The utility of bone cement to prevent lead migration with minimally invasive placement of spinal cord stimulator laminectomy leads.
BACKGROUND
Lead migration is a significant concern with spinal cord stimulator (SCS) placement with rates ranging from 10% to 60%.


OBJECTIVE
To describe a novel technique using bone cement at the laminotomy site to help prevent lead migration after minimally invasive placement of laminectomy paddle leads and to present our short-term results.


METHODS
A review of a prospectively maintained database identified all patients who underwent minimally invasive placement of laminectomy leads with the use of bone cement. All procedures were performed between July 2008 and August 2010 with conscious sedation and local anesthetic. Intraoperative testing was performed to confirm good pain coverage. A small volume of bone cement (1-3 cm) was then placed to cover the laminectomy defect. Radiographic and clinical follow-up was assessed.


RESULTS
Forty-two patients (mean age, 58.0 years) underwent 42 procedures. Back pain (88.1%) and leg pain (88.6%) were the most common presenting symptoms. No intraoperative complications were noted. Two patients (4.8%) required removal of their devices because of nonhealing wounds. All patients were followed up for a minimum of 6 months, and no cases of clinical or radiographic lead migration were seen at the time of publication.


CONCLUSIONS
We present a novel technique in the hopes of decreasing the incidence of lead migration after minimally invasive placement of spinal cord stimulator laminectomy paddle leads. Our results have been promising thus far with no cases of lead migration.
Department of Neurosurgery, Louisiana State University Health Sciences Center-Shreveport, Shreveport, LA 1130-3932, USA.
David E
DE
Connor
Aileen
A
Cangiano-Heath
Benjamin
B
Brown
Ryan
R
Vidrine
Toussaint
T
Battley
Anil
A
Nanda
Bharat
B
Guthikonda
D000328:Adult; D000368:Aged; D001843:Bone Cements / Q000627:therapeutic use*; D004599:Electric Stimulation Therapy / Q000009:adverse effects; D004567:Electrodes, Implanted / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000517:prevention & control*; D006801:Humans; D007796:Laminectomy / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013118:Spinal Cord Diseases / Q000601:surgery; D013997:Time Factors
D001843:Bone Cements