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  • Restoration of Efficacy of Spinal Cord timulation After Conversion From Percutaneous to Paddle Leads

    Final Number:

    Chen Xu M.D.; Raj Kiran Nangunoori MD; Nestor Denys Tomycz MD

    Study Design:

    Subject Category:

    Meeting: 2016 ASSFN Biennial Meeting

    Introduction: Spinal cord stimulation (SCS) is widely used for conditions such as failed back surgery syndrome (FBSS) and complex regional pain syndrome (CRPS I and II). While percutaneous or paddle lead systems are both viable options, percutaneous lead systems have a tendency to lose efficacy due to a higher migration rate, resulting in loss of clinical efficacy.

    Methods: A retrospective chart review was conducted to identify patients who had lost efficacy from their percutaneous SCS systems and were converted to a paddle lead system, regardless of etiology.

    Results: From 2013 to 2016, 7 patients were identified with a mean age of 54.8 years (range: 32-80) who had received benefit from percutaneous lead systems and presented for evaluation with loss of efficacy. A total of 5 male and 2 female patients underwent conversion from percutaneous to paddle lead systems with a restoration and/or improvement in their symptom coverage. Diagnoses included FBSS (71.43%) and CRPS (28.57%), with a mean follow-up duration of 21 months (range: 2-36 months).

    Conclusions: Failure of percutaneous SCS stimulation should not deter using SCS as a treatment modality for patients with a recurrence of their symptoms. While patients should be evaluated on a case-by-case basis, conversion to a paddle-lead system may allow for recapture of their clinical benefit and improve quality of life.

    Patient Care: To allow recapture of patients' previous clinical benefit from SCS, improve quality of life, and not consider these patients as those who failed SCS.

    Learning Objectives: To show recapture of clinical efficacy of SCS after conversion to paddle lead system from percutaneous lead system


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