Utilization of Leads After Permanent Implant in Spinal Cord Stimulator Systems

Abstract

To our knowledge this is the first descriptive analysis of the frequency of single- and dual-lead SCS systems. This report indicates that dual-lead systems are most often placed and both leads are required for optimal patient therapy.

A Retrospective Database Review of the Indications, Complications, and Incidence of Subsequent Spine Surgery in 12,297 Spinal Cord Stimulator Patients

“…Mekhail et al reported a higher incidence of FBSS (33.2%) diagnosis in retrospective review of 707 SCS patients . Likewise, Sanders et al in a review of 259 SCS patients reported FBSS (40.5%) and CRPS (21.2%) as the most common indications for SCS, amongst other non‐spine‐related indications such as angina (12.4%), and peripheral neuropathy‐related pain . FBSS and CRPS widely remain the most common indications for SCS till date .…”

The Evolution of Surgical Technique in Spinal Cord Stimulation: A Scoping Review

“…From the time of Shealy, leads and where they are placed have evolved from the vitallium and platinum single electrodes placed surgically at the corresponding pain location to a wide selection of percutaneous leads and multicolumn paddles placed largely in the T8-T10 levels for back and leg pain relief. 1,52,53 Multicolumn leads allowed for better energy shaping, which could create longitudinal tripoles and activate transverse electric fields. 52,54 Our current armamentarium of paddle leads contains 8 to 32 contacts.…”

“…1,52,53 Multicolumn leads allowed for better energy shaping, which could create longitudinal tripoles and activate transverse electric fields. 52,54 Our current armamentarium of paddle leads contains 8 to 32 contacts. 53 Paddle lead placement requires full laminectomy and/or hemilaminectomy approaches.…”

Fantastic Four: Age, Spinal Cord Stimulator Waveform, Pain Localization and History of Spine Surgery Influence the Odds of Successful Spinal Cord Stimulator Trial

“…From a pragmatic standpoint, most interventional pain physicians use dual leads with the assumption that they allow for more versatile programming and better pain coverage (15,17,27,51,58). It has also been conjectured that dual leads serve as a safeguard against lead migration by expanding one's options for salvage reprogramming in the event that lead migration does occur (17,27,59). Incidentally, reports of the superiority of single vs dual leads have been mixed (15,51,(58)(59).…”

“…It has also been conjectured that dual leads serve as a safeguard against lead migration by expanding one's options for salvage reprogramming in the event that lead migration does occur (17,27,59). Incidentally, reports of the superiority of single vs dual leads have been mixed (15,51,(58)(59). Although this retrospective analysis shows no differences between single vs dual leads in our study cohort, we anticipate that larger well-designed controlled trials may help ascertain which practice is more cost-effective (60).…”