Laminoplasty for Cervical Spinal Cord Stimulator Implantation in Patients With Cervical Spondylosis and Fusion: A Technical Note

Abstract

Background: Epidural spinal cord stimulator (SCS) implantation is a commonly used strategy for treating refractory neuropathic pain, but the literature on the technical aspects of cervical SCS surgery remains scarce. Degenerative cervical stenosis and prior fusion surgery are relatively frequent conditions in this population, and the optimal method for cervical lead placement among such patients has not been established. Decompressive laminectomy may be required for cervical SCS placement in the presence of spinal stenosis. However, extensive decompression may increase the rate of lead migration and destabilize the spine, especially when performed above an existing fusion. Case Series: We present a surgical technique for cervical SCS implantation and the cases of 3 patients with significant spinal stenosis and/or prior fusion. In these patients, the paddle lead placement was safely achieved using cervical laminoplasty techniques. Conclusion: In addition to stabilizing the epidural paddle lead, laminoplasty offers several potential advantages compared to decompression alone.

Management of post-cervical laminectomy fusion pain syndrome with a successful trial of spinal cord stimulation

“… 3 , 7 , 10 , 13 Denis et al have published their experience with the use of laminectomy in cervical lead placement. 6 …”

“…3,7,10,13 Denis et al have published their experience with the use of laminectomy in cervical lead placement. 6 The procedure is not without risk. Cervical spinal cord stimulator lead placement itself has been reported to lead to epidural fibrosis, 2 so a high degree of suspicion for complication from fibrosis must be maintained through follow-up.…”