Paddle Versus Cylindrical Leads for Percutaneous Implantation in Spinal Cord Stimulation for Failed Back Surgery Syndrome: A Single-Center Trial
Paddle Versus Cylindrical Leads for Percutaneous Implantation in Spinal Cord Stimulation for Failed Back Surgery Syndrome: A Single-Center Trial
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DOI：
10.1055/s-0034-1371517
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发表时间：
2014-11-01
影响因子：
1
通讯作者：
Vesper, Jan
中科院分区：
文献类型：
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作者：
Kinfe, Thomas M.;Quack, Florian;Vesper, Jan
目的脊髓刺激是一种针对慢性疼痛综合征（例如背部手术失败综合征（FBSS））的介入治疗方法，它利用经皮放置到硬膜外腔的圆柱形或桨状电极。这项前瞻性非随机单中心研究调查了经皮植入电极板和圆柱形导线在 FBSS 患者中的具体优点和缺点。方法在 2 年时间内，纳入了 100 名 FBSS 患者（43 名男性；57 名女性；平均年龄：56.3 岁）。 50 名患者在局部麻醉下经皮放置电极引线；其余 50 名患者接受常规经皮圆柱形导线植入（每名患者允许一根导线）。随访包括疼痛视觉模拟量表 (VAS) 评估和 Oswestry 残疾问卷的管理。结果两组均显示出相似的显着疼痛减轻 (69%)（VAS 前/后：桨：8.8/3.7；圆柱：8.5/3.8）。每组采用相同的围手术期方案，我们观察到圆柱形组的脱位和感染率（分别为 14% 和 10%）高于桨组（分别为 6% 和 2%）。 结论 微创经皮桨式和圆柱形引线安全有效，并发症发生率低，在 FBSS 患者中表现良好。两种装置都可以使用局部麻醉剂植入，以便在永久装置固定之前可以进行术中和可重复的测试刺激以获得足够的感觉异常重叠。
ObjectiveSpinal cord stimulation is an interventional treatment for chronic pain syndromes such as failed back surgery syndrome (FBSS), and it utilizes either cylindrical or paddle electrodes placed percutaneously into the epidural space. This prospective nonrandomized single-center study investigated the specific advantages and disadvantages of percutaneously implanted paddle and cylindrical leads in patients with FBSS.MethodsOver a 2-year period, 100 patients with FBSS (43 men; 57 women; mean age: 56.3 years) were included. Paddle leads were placed percutaneously under local anesthesia in 50 patients; conventional percutaneous cylindrical lead implantation was performed in the other 50 patients (one lead permitted per patient). Follow-up included the Visual Analog Scale (VAS) assessment of pain and administration of the Oswestry Disability Questionnaire.ResultsSimilar significant pain reduction (69%) was demonstrated in both groups (VAS pre/post: paddle: 8.8/3.7; cylindrical: 8.5/3.8). Using the same perioperative protocol for each group, we observed higher dislocation and infection rates for the cylindrical group (14% and 10%, respectively) than for the paddle group (6% and 2%, respectively).ConclusionMinimally invasive percutaneous paddle and cylindrical leads are safe and effective, have low complication rates, and perform well in patients with FBSS. Both devices can be implanted using a local anesthetic, so that intraoperative and reproducible testing stimulation can be performed for sufficient paresthesia overlap prior to permanent device fixation.