title: Impact to spinal cord stimulator lead integrity with direct suture loop ties.
abstract: BACKGROUND
  Lead migration of spinal cord stimulators (SCS) is a significant problem, and experience suggests that anchoring sutures directly around the SCS lead may reduce migration. Such practices have been limited by concerns about potential damage to the lead and impairment of performance.
  
  
  OBJECTIVE
  This study sought to determine the extent of overt damage following maximal tension from tying sutures directly around SCS leads.
  
  
  METHODS
  Twenty-eight SCS leads were prospectively exposed to 56 suture knots that were tightened under controlled conditions to the suture's breaking point.
  
  
  METHODS
  Lead damage was evaluated by high power microscopy and assessment of lead impedance.
  
  
  RESULTS
  None of the leads had evidence of substantial physical damage or electrical impairment.
  
  
  CONCLUSIONS
  This small study suggests that anchoring directly to the lead appears to produce minimal damage, but these preliminary data must be confirmed and expanded.
authors.affiliation: Division of Pain Medicine, Department of Anesthesiology and Pain Medicine, University of California, Davis, California, USA. pgkreis@ucdavis.edu
authors.forename: Paul G
authors.initials: PG
authors.lastname: Kreis
authors.forename: Scott M
authors.initials: SM
authors.lastname: Fishman
authors.forename: Katherine
authors.initials: K
authors.lastname: Chau
mesh_terms: D004599:Electric Stimulation Therapy; D004567:Electrodes, Implanted; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods*; D013116:Spinal Cord / Q000601:surgery*; D013536:Suture Techniques; D013718:Tensile Strength