Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Department of Neurological Surgery, Kurashiki-Heisei Hospital, Okayama, Japan.
World Neurosurg. 2018 May;113:e391-e398. doi: 10.1016/j.wneu.2018.02.040. Epub 2018 Feb 14.
Optimal placement of electrodes is important for spinal cord stimulation. Factors affecting the difficulty of percutaneous electrode placement are not well known. In this study, we retrospectively evaluated the factors affecting the difficulty of percutaneous electrode placement.
We performed a retrospective analysis of 90 consecutive procedures of percutaneous cylindrical electrode implantation at the first author's institution. Age, sex, smoking state, body mass index, the duration of time from the beginning of pain syndrome to operation, diagnosis, the number of previous electrode placements, the previous electrode implantation period, the presence of axial low back pain, the electrode tip level, the pattern of electrode placement, and the reason for reimplantation were selected as factors associated with the success of electrode placement or the operation time of electrode placement.
The number of previous electrode placements and the electrode tip level were independently associated with the operation time of electrode placement. According to both univariable and multivariable regression analyses, 1 previous electrode placement lengthened the operation time by approximately 15 minutes. No factors were significantly associated with the success of electrode placement. The more frequently that previous electrode placement was performed, the more difficult electrode placement tended to be. However, electrode reimplantation can be successful given extra time.
This is the first study to evaluate factors affecting the difficulty of percutaneous electrode placement. A history of percutaneous cylindrical electrode placement did not affect the success of current placement, although it lengthened the operation time.
电极的最佳放置位置对于脊髓刺激至关重要。影响经皮电极放置难度的因素尚不清楚。在这项研究中，我们回顾性评估了影响经皮电极放置难度的因素。
我们对第一作者机构进行的 90 例经皮圆柱电极植入连续手术进行了回顾性分析。选择年龄、性别、吸烟状态、体重指数、从疼痛综合征开始到手术的时间、诊断、以前电极放置的数量、以前电极植入的时间、轴向腰痛的存在、电极尖端水平、电极放置模式和重新植入的原因作为与电极放置成功或电极放置时间相关的因素。
以前电极放置的数量和电极尖端水平与电极放置时间独立相关。根据单变量和多变量回归分析，以前进行过 1 次电极放置会使手术时间延长约 15 分钟。没有因素与电极放置的成功率显著相关。以前进行过更多次的电极放置，电极放置的难度就越大。然而，只要有额外的时间，电极的重新植入就可以成功。
这是第一项评估影响经皮电极放置难度因素的研究。经皮圆柱电极放置的既往史虽然会延长手术时间，但并不影响当前放置的成功率。
