Introduction: Although the long-term outcomes for spinal cord stimulation (SCS) have been reported, long-term outcomes of patients who underwent revisions of the SCS with paddle leads are lacking. We report the long-term outcomes of 39 patients that had percutaneous SCS revised with a new paddle lead.
Methods: Baseline and follow-up mail-in questionnaires assessed pain and disability levels, somatotopical overlap between SCS-related paresthesias and areas of chronic pain, and overall satisfaction. Analysis was performed with regard to age, gender, diagnosis, duration of disease, number of surgical revisions, complications, and interval between surgeries.
Results: After surgical revision, 20 patients (50%) had at least 3 point reduction in the numerical rating scale. Greater pain reduction was correlated with better coverage (P = .001). Coverage area was greater in patients with a single revision than patients with multiple revisions (P = .01). Good satisfaction was reported by 25 patients (62.5%) who indicated that they would undergo the procedure again in order to achieve the same results. These patients had significantly greater pain reduction (P = .001) and better coverage (P = .002) than patients who reported otherwise. No other major complication occurred.
Conclusions: Revision of percutaneous SCS systems with implantation of a new paddle lead is safe and more effective in patients who have undergone not more than one prior revision.
Patient Care: This research will improve patient care by reporting factors correlated with the outcomes of replacing percutaneous leads with paddle leads in patients with failed spinal cord stimulation systems.
Learning Objectives: By the conclusion of this session, participants should be able to: 1)Identify common indications of spinal cord stimulation, 2)Identify common causes of spinal cord stimulation failure, 3)Discuss the outcomes of replacement of percutaneous leads with paddle leads in patients with spinal cord stimulation systems, 4)Discuss factors correlated with these outcomes.