title: Prevention of percutaneous spinal cord stimulation electrode migration: a 15-year experience.
abstract: OBJECTIVE
  Percutaneous spinal cord stimulation electrodes have a propensity to migrate longitudinally, which is a costly complication that often compromises therapeutic effect. After implementing simple changes to our percutaneous electrode anchoring technique, we no longer encounter this migration. The current retrospective study updates previously reported results.
  
  
  METHODS
  We retrospectively examined data in a consecutive series of patients in whom we had secured a new percutaneous electrode by injecting < 0.1 cm(3) of adhesive into the silicone elastomer lead anchor. From 1998 through 2006, we used whichever anchor was supplied with each lead until we observed one case of migration through a short anchor; thereafter, we used a long, tapered anchor exclusively. From 2007 through 2013, we further modified our technique by adding a fascial incision to accommodate the tip of the anchor and by increasing the strength of our suture material.
  
  
  RESULTS
  In the first series of 291 patients, followed through July 2007 (mean 4.75 years, range 1.1-9.0 years), 4 (1.37%) experienced electrode migration requiring surgical revision. Only one lead had moved with respect to its anchor; the other three anchors remained securely bonded to their leads. No migration (0.00%) occurred in the second series of 142 patients, followed through 2013 (mean follow-up 2.86 years, range 0.10-5.45 years).
  
  
  CONCLUSIONS
  Improvements to our simple, inexpensive technique apparently have eliminated the most common complication of spinal cord stimulation.
authors: The Johns Hopkins University School of Medicine (retired), Baltimore, MD, USA; Neuromodulation Foundation, Incorporated, Baltimore, MD, USA.
authors: Richard B
authors: RB
authors: North
authors: Violette R
authors: VR
authors: Recinos
authors: Frank J
authors: FJ
authors: Attenello
authors: Jane
authors: J
authors: Shipley
authors: Donlin M
authors: DM
authors: Long
mesh_terms: D000368:Aged; D004567:Electrodes, Implanted / Q000009:adverse effects*; D005260:Female; D005548:Foreign-Body Migration / Q000209:etiology* / Q000517:prevention & control*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012867:Skin / Q000294:innervation*; D062187:Spinal Cord Stimulation / Q000009:adverse effects*
keywords: Complications; electrode migration; percutaneous electrodes; spinal cord stimulation; technique