Prevention of Mechanical Failures in Implanted Spinal Cord Stimulation Systems

Incidence and Avoidance of Neurologic Complications with Paddle Type Spinal Cord Stimulation Leads

“…There is no generally agreed-upon method for anchoring a paddle electrode, although biomechanical (27) and other studies have led to some recommendations (16). If an extensive laminectomy is performed, anchoring the electrode to the dura using a partial thickness suture can help prevent mediolateral or craniocaudal migration.…”

“…If an extensive laminectomy is performed, anchoring the electrode to the dura using a partial thickness suture can help prevent mediolateral or craniocaudal migration. Using an anchor applied to the wire emanating from the paddle is not recommended, because of the increased stress placed on the electrode with this arrangement (27). Some investigators have suggested using biologic or cyanoacrylate or silicone elastomer adhesive to secure the lead in position (28).…”

Spinal Cord Stimulation for Chronic Pain: Causes of Long-Term Paddle-Lead Failure

“…These modifications resulted in no lead malfunction in the last 40 patients during the same follow-up period. Computer modeling of the shear forces on SCS leads implanted in the thoracic spine was studied recently and the incidence of lead fractures was predicted to be reduced 65 times by using a soft plastic anchor underneath the fascia (14). While other authors had reported that IPG location played a pivotal role in lead displacement (13), we have encountered only one lead displacement in the cervical region due to the twist lock failure.…”

Drivers and Risk Factors of Unplanned 30-Day Readmission Following Spinal Cord Stimulator Implantation

“…18 Lead breakage is another common hardware complication of SCS; to circumvent this problem, Henderson et al developed a computer model to simulate SCS movement and found that paramedian placement of leads as well as abdominal pulse generator placement reduced the incidence of breakage and increased SCS hardware longevity. 20 Despite these advances, we found that hardware complications remain a common cause of unplanned readmission after SCS. Given the recent technological evolution of SCS devices, future studies are necessary to monitor whether more recent hardware improvements lead to better patient outcomes and lower readmission rates.…”