Introduction: The authors investigated the difference in clinical outcome and the position of paddle lead spinal cord stimulation (SCS) between three-column and five-column paddle lead SCS in patients with FBSS

Methods: In 21 patientswho underwent paddle lead SCS at T9 (three-column [n=12] and five-column [n=9]) for FBSS, a 12-month follow-up numerical rating scale, percent pain relief, and CT assessment of contact angle and percent reduction of T9 canal areawere investigated.

Results: There was no difference in paresthesia coverage of the painful area, trial success rate, clinical outcomes, and percent pain relief between the two groups(p>0.05).Although there was no statistical difference in the contact angles, the contact angle in the five-column group was generally greater than that of the three-column group (p=0.067). Overall reduction of 35.51 ± 4.76% in the T9 canal was observed and there was no difference between two groups (p>0.05) and no correlation between the contact angle and percent T9 spinal canal reduction (r = -0.247,p>0.05).

Conclusions: There was no difference in clinical efficacy of SCS using three and five-column paddle lead. Significant inclination of paddle lead in posterior epidural space and significant reduction in T9 canal area were observed.

Patient Care: This presentation would be of help for neurosurgeons to place correctly in T8/9 epidural space

Learning Objectives: to provide a real location of paddle lead for T8,9 epidural space and to help physicians to enhance the performance of paddle lead insertion and patient programming.

References: 1.Son B, Kim D, Lee S, Chough C. Factors associated with the success of trial spinal cord stimulation in patients with chronic pain from failed back surgery syndrome. J KorNeurosurgSoc 2013;54:501-506. 2.Struijik JJ, Holsheimer J, Spincemaille GHJ, Gielen FLH, Hoekema R. Theoretical performance and clinical evaluation of transverse tripolar spinal cord stimulation. IEEE Trans RehabilEng 1998;6:277-283.