title: A Novel Nonanchoring Technique for Implantation of Paddle Leads in the Cervical Spine Under Conscious Sedation.
abstract: OBJECTIVE
  Spinal cord stimulation (SCS) revision surgery remains common, with a negative impact on cost-effectiveness and outcomes. The primary goal of this report was to retrospectively study the need for revision surgery in a cohort of complex regional pain syndrome type I (CRPS-1) patients with newly implanted cervical surgical paddle leads, focusing on a method of implantation to reduce the need for revision surgery.
  
  
  METHODS
  Fifteen patients underwent implantation of paddle SCS leads in the cervical spine with cervical laminotomies under conscious sedation for CRPS-1 from 2008 to 2012. Electrodes were not anchored and 11 of the electrodes were three-column paddle leads. A disinterested third party performed initial chart reviews, supplemented by subsequent telephone interviews. The need for revision surgery was the endpoint. A single surgeon performed all implants with a consistent method.
  
  
  RESULTS
  There were no paddle electrode lead revisions required for suboptimal lead placement, fracture, migration, or infection at a median follow-up period of 22 months.
  
  
  CONCLUSIONS
  This study is the first to report on: 1) cervical electrode implantation with no anchoring; and 2) cervical paddle lead implantation (including three-column paddles) performed under conscious sedation. The specific method of nonanchoring of the paddle implants under conscious sedation may have contributed to low electrode lead revision rates.
authors: Peter A
authors: PA
authors: Pahapill
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae; D015331:Cohort Studies; D020918:Complex Regional Pain Syndromes / Q000628:therapy*; D016292:Procedural Sedation; D004567:Electrodes, Implanted; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D013116:Spinal Cord / Q000502:physiology*; D062187:Spinal Cord Stimulation / Q000295:instrumentation* / Q000379:methods*; D016896:Treatment Outcome
keywords: Anchoring; SCS; case series; complex regional pain syndrome; electrode paddle; electrode placement; hardware failure; retrospective study