title: Percutaneously implanted plates in failed back surgery syndrome (FBSS).
abstract: OBJECTIVE
  To evaluate the clinical efficacy of pain suppression in back area and lower extremities by recently developed plate electrodes for spinal cord stimulation through percutaneous access.
  
  
  METHODS
  A retrospective analysis is performed: 20 consecutive patients with both lower extremity pain and low back pain, with low back counting for at least 30% of the overall pain were implanted with a small profile plate type lead, S-Series (SJM), via percutaneous approach. Patients were asked to rate their back and leg pain as well as their overall satisfaction and data on quality of life (QOL) on a (0-10 point) visual analog scale (VAS) before and after implantation. Medication use, functional pain (pain when bending forward, moving), and patient satisfaction scores also were collected.
  
  
  RESULTS
  A significant reduction of 55% and 45.7% in, respectively, VAS legs and VAS back pain was found. One year postoperatively the reduction was still present, respectively, 43% and 27% for the legs and the back. In 17 patients (85%) a clinically relevant reduction (defined as reduction of 2 points or 30% in VAS) in back pain was seen, with a mean decrease of 4.3 points (2.0-10.0) or 52% (22-100). Only three patients had no reduction in back pain, although they had reduction of their pain in the lower extremities. A significant and clinically relevant improvement of 66% and 70% was seen, respectively, for general satisfaction and QOL, respectively. One year postoperatively this improvement was still present, respectively, 69% and 75% for the satisfaction and QOL. Importantly functional pain also decreased by 51%. No infections occurred. Mean duration of post-op wound pain was 13.5 hours.
  
  
  CONCLUSIONS
  Percutaneous implantation of the S-Series plate electrodes using a 10 gauge epidural needle combines the advantages of a minimal invasive technique with the possibility to cover the back area supplementing leg coverage in 85% of the failed back surgery syndrome patients.
authors: Department of Anesthesiology & Invasive Paintherapy, Sint Maartenskliniek Nijmegen, Nijmegen, The Netherlands. l.vonhogen@maartenskliniek.nl
authors: Leon H
authors: LH
authors: Vonhögen
authors: Tim
authors: T
authors: Vancamp
authors: Sven
authors: S
authors: Vanneste
authors: Wim
authors: W
authors: Pollet
authors: Ris
authors: R
authors: Dirksen
authors: Pauline
authors: P
authors: Bakker
authors: Ingrid
authors: I
authors: Mestrom
authors: Theo
authors: T
authors: van de Looij
authors: Mark
authors: M
authors: Plazier
authors: Dirk
authors: D
authors: de Ridder
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D004599:Electric Stimulation Therapy / Q000295:instrumentation* / Q000379:methods; D004567:Electrodes, Implanted; D055111:Failed Back Surgery Syndrome / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000295:instrumentation* / Q000379:methods*; D010147:Pain Measurement; D012189:Retrospective Studies