Schoen Nathan, Chieng Lee Onn, Madhavan Karthik, Jermakowicz Walter J, Vanni Steven
Department of Neurological Surgery and the Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, Florida, USA.
Department of Neurological Surgery and the Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, Florida, USA.
World Neurosurg. 2017 Apr;100:74-84. doi: 10.1016/j.wneu.2016.12.077. Epub 2016 Dec 27.
Spinal cord stimulation (SCS) is an efficacious treatment for various chronic pain syndromes culminating predominantly into spinal nerves. To improve intraoperative electrode placement, several groups have advocated the use of intraoperative neuromonitoring for localization of the spinal cord midline. In our study we present the case series of patients undergoing stimulator placement with consistent electromyographic intraoperative testing, with an emphasis on examining reoperation rates and complications.
After approval from the institutional review board, we retrospectively collected data on standard demographics, preoperative diagnoses, prior spine surgeries, electrode manufacturer, blood loss, complications, and patient outcome.
The study included 103 patients with an average age of 60.7 years. Of these, 72 (69.9%) had prior spine surgery, which was associated with higher rate of reoperation (P = 0.019). The mean latency between initial SCS implantation and revision surgery ± SD was 14.6 ± 17.2 months, with a median time of 280 days. There was a 13.6% complication rate. Common complications that lead to reoperation included migrated electrode or failed generator.
Our retrospective chart review of 103 patients indicates that patients receiving SCS implantation in conjunction with electromyographic monitoring have low complication rates and rarely return to the operating room for electrode repositioning or removal.
脊髓刺激（SCS）是治疗各种慢性疼痛综合征的有效方法，这些综合征主要累及脊神经。为了改善术中电极放置，多个研究小组主张使用术中神经监测来定位脊髓中线。在我们的研究中，我们展示了一系列接受刺激器植入且术中肌电图测试结果一致的患者病例，重点是检查再次手术率和并发症。
经机构审查委员会批准后，我们回顾性收集了有关标准人口统计学、术前诊断、既往脊柱手术史、电极制造商、失血量、并发症和患者预后的数据。
该研究纳入了103例患者，平均年龄为60.7岁。其中，72例（69.9%）有既往脊柱手术史，这与较高的再次手术率相关（P = 0.019）。初次SCS植入与翻修手术之间的平均间隔时间±标准差为14.6±17.2个月，中位时间为280天。并发症发生率为13.6%。导致再次手术的常见并发症包括电极移位或发生器故障。
我们对103例患者的回顾性病历审查表明，接受SCS植入并进行肌电图监测的患者并发症发生率较低，很少因电极重新定位或取出而返回手术室。
