Departments of Neurosurgery, Beaumont Neuroscience Center, Royal Oak, Michigan, USA; Departments of Neurosurgery, Oakland University William Beaumont School of Medicine, Rochester, Michigan, USA.
World Neurosurg. 2024 Feb;182:e891-e898. doi: 10.1016/j.wneu.2023.12.080. Epub 2023 Dec 20.
Spinal cord stimulators (SCSs) can be implanted via a percutaneous or paddle approach, the latter technique requiring a laminotomy or laminectomy. Revision surgery may be necessary in instances of migrated, misplaced, or failed stimulators. When revision of a percutaneous system is necessary, it is common to replace the electrodes with a paddle SCS. This study aims to describe a case series of patients with failed paddle SCS electrodes who underwent revision with percutaneous SCS hardware.
A series of 5 patients were retrospectively analyzed. Medical records were reviewed for demographic data, operative technique, postoperative follow-up, and complications.
Five patients were included in this series. The median age was 63 (range 51-84), and the median duration from initial implantation to revision surgery was 19 months (range 5-60). The median operative duration was 92 minutes (mean 99 ± 19.6 minutes). The median length of follow-up after surgery was 24 months (mean 21.8 ± 6.0 months). All patients had improved pain relief and therapeutic coverage with no complications.
Paddle-to-percutaneous SCS surgery is a feasible and durable revision option in appropriately selected patients.
脊髓刺激器（SCSs）可通过经皮或桨式方法植入，后者技术需要进行椎板切开术或椎板切除术。在刺激器迁移、错位或失效的情况下，可能需要进行翻修手术。当需要对经皮系统进行翻修时，通常用桨式 SCS 更换电极。本研究旨在描述一组接受经皮 SCS 硬件翻修的桨式 SCS 电极失效患者的病例系列。
回顾性分析了一系列 5 例患者。对患者的人口统计学数据、手术技术、术后随访和并发症进行了回顾性分析。
本系列包括 5 例患者。中位年龄为 63 岁（范围 51-84 岁），从初次植入到翻修手术的中位时间为 19 个月（范围 5-60 个月）。中位手术时间为 92 分钟（平均 99 ± 19.6 分钟）。术后中位随访时间为 24 个月（平均 21.8 ± 6.0 个月）。所有患者的疼痛缓解和治疗效果均得到改善，且无并发症发生。
在适当选择的患者中，桨式到经皮 SCS 手术是一种可行且持久的翻修选择。
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