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. 2025 Oct 15.
doi: 10.1227/ons.0000000000001801. Online ahead of print.

Minimally Invasive Spinal Cord Stimulator Paddle Electrode Placement: Technique and Complications in a Single Surgeon Cohort

Peter G Cruz-Gordillo  1   2   3 , Antonia L Gragg  1   4 , Donald A Ross  1   2   3
Affiliations

Minimally Invasive Spinal Cord Stimulator Paddle Electrode Placement: Technique and Complications in a Single Surgeon Cohort

Peter G Cruz-Gordillo et al. Oper Neurosurg. .

Abstract

Background and objectives: Spinal cord stimulation (SCS) is a widespread tool used to treat chronic pain. There are 2 primary methods for permanent implantation of SCS: electrode lead placement through percutaneous needle or paddle electrodes by open laminotomy. The goal of this report was to use a tubular, minimally invasive method to implant SCS paddles, describe the feasibility and safety of the method, and provide a companion video illustration of the technique.

Methods: One-hundred two minimally invasive spinal cord stimulator paddle electrode procedures were performed on 76 men and 26 women. We completed a retrospective review of the placement, replacement, and removal of spinal cord stimulator paddle electrodes in this single-surgeon cohort of patients to assess the procedure's feasibility and any technical issues encountered.

Results: There were 86 primary system placements; 11 paddle electrode replacement procedures for lead fractures, lead migration, or revision of the entire system; and 5 procedures for the complete removal of spinal cord stimulator systems without replacement. There were no neurological deficits or epidural hematomas. There was 1 single infection of the device requiring removal and eventual replacement (0.98%), etiology assessed to be likely secondary to dental abscess, not the SCS procedure itself.

Conclusion: We describe a minimally invasive tubular access mediated method, whereby paddle electrodes can be placed successfully with minimal morbidity. We describe any technical issues, provide an accompanying narrated video of an illustrative case, and describe techniques for dealing with paddle migration including the removal of a paddle lead using tubular access.

Keywords: Minimally invasive surgery; Paddle electrode; Spinal cord stimulator.

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References

    1. GBD 2015 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1545-1602.
    1. Dutmer AL, Schiphorst Preuper HR, Soer R, et al. Personal and societal impact of low back pain. The Groningen spine cohort. Spine. 2019;44(24):E1443-E1451.
    1. Bean LL, Goon M, McClure JJ, et al. The evolution of surgical technique in spinal cord stimulation: a scoping review. Oper Neurosurg. 2024;26(4):372-380.
    1. Schmidt GL. The use of spinal cord stimulation/neuromodulation in the management of chronic pain. J Am Acad Orthop Surg. 2019;27(9):E401-E407.
    1. Kinfe TM, Quack F, Wille C, Schu S, Vesper J. Paddle versus cylindrical leads for percutaneous implantation in spinal cord stimulation for failed back surgery syndrome: a single-center trial. J Neurol Surg A Cent Eur Neurosurg. 2014;75(6):467-473.

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