Orthopedic & Muscular System: Current Research
Open Access
ISSN: 2161-0533
+44-20-4587-4809
ISSN: 2161-0533
+44-20-4587-4809
Mark Bender
University of South Florida, USA
Posters & Accepted Abstracts: Orthop Muscular Syst
Spinal cord stimulation (SCS) utilizing paddle lead placement in the upper cervical spine remains difficult due to the dynamics of the vertebral anatomy and relative paucity of data regarding optimal surgical technique. Equipment optimization and improving surgical proficiency are paramount to maximize patient outcomes. Our objective was to determine if a posterior approach utilizing a thoracic paddle lead in the upper cervical spine could yield results which were superior to previously reported techniques. We report a case series which was conducted over a 6 year period, from 2008-2014. 32 patients, ages 35-96, with diagnoses that included reflex sympathetic dystrophy, cervical post laminectomy syndrome and degenerative disc disorder were included in this study. Symptomatic complaints included, but were not limited to, occipital headaches, axial cervical pain and upper extremity neuropathic pain. All patients had failed conservative medical management which included opiate and non-opiate medications, as well as previous surgical correction. Outcome measures included surgical revisions, post-operative complications and lead removal for any/all causes. The range of follow-up was 3 months to 2 years. Seven lead revisions were performed in total, four of which were due to lead migration. Two of the remaining patients fractured or dislodged their leads as a result of a fall and one pulse generator wound infection was noted. No significant spinal cord injury or neurologic sequelae occurred in this sample and blood loss was minimal. In conclusion, we have demonstrated this technique to be a safe and effective method of lead implantation with reduced morbidity in comparison with previous techniques which have utilized alternative anchoring methods.
Email: markbender@health.usf.edu