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