Department of Neurological Surgery, Henry Ford Hospital, Detroit, MI, USA.
Neuromodulation. 2014 Dec;17(8):759-62; discussion 762. doi: 10.1111/ner.12174. Epub 2014 Apr 11.
The objective of this study is to present a novel surgical technique for safe placement of paddle-type spinal cord stimulation (SCS) electrode in the presence of epidural scar tissue.
We developed a new surgical technique for placement of paddle-type SCS electrode in presence of epidural scar tissue when conventional placement methods had failed. The technique involves creating a laminotomy trough to provide an adequate window for dissection of scar tissue to ensure safe placement of the electrode. We have applied this technique in eight patients.
Safe placement of SCS electrode was achieved in all eight patients without any complications. All electrodes were placed between T8 and T10 levels, and we were able to place the electrodes in the midline and achieve adequate coverage in all cases.
SCS is a widely accepted treatment modality for chronic neuropathic pain. Placement of paddle electrode can be challenging, usually because of the presence of epidural scar tissue. There have been reported cases of spinal cord injury related to paddle electrode placement. We present a novel technique that allows for safe placement of a paddle-type SCS electrode in more challenging surgical circumstances, including the presence of epidural scar tissue.
本研究旨在介绍一种新的手术技术，用于在存在硬膜外瘢痕组织的情况下安全放置桨式脊髓刺激（SCS）电极。
当传统的放置方法失败时，我们开发了一种在存在硬膜外瘢痕组织的情况下放置桨式 SCS 电极的新技术。该技术涉及创建一个椎板切开槽，为解剖瘢痕组织提供足够的窗口，以确保电极的安全放置。我们已经在八名患者中应用了该技术。
所有八名患者均成功安全地放置了 SCS 电极，没有任何并发症。所有电极均置于 T8 至 T10 水平，并且我们能够将电极置于中线，并在所有情况下实现足够的覆盖。
SCS 是治疗慢性神经性疼痛的广泛接受的治疗方式。桨式电极的放置可能具有挑战性，通常是因为存在硬膜外瘢痕组织。有报道称与桨式电极放置相关的脊髓损伤病例。我们提出了一种新的技术，可在更具挑战性的手术情况下安全地放置桨式 SCS 电极，包括存在硬膜外瘢痕组织的情况。
