A Retrospective Review of Lead Migration Rate in Patients Permanently Implanted with Percutaneous Leads and a 10 kHz SCS Device.

A Retrospective Review of Lead Migration Rate in Patients Permanently Implanted with Percutaneous Leads and a 10 kHz SCS Device.
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DOI:
10.1155/2021/6639801
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发表时间:
2021
影响因子:
2.9
通讯作者:
Rotte A
Rotte A
中科院分区:
医学3区
文献类型:
--
作者:
Gupta M;Abd-Elsayed A;Hughes M;Rotte A

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脊髓电刺激(SCS)已用于疼痛管理数十年,但经皮电极导线移位是最常见的并发症。更好的手术技术和更新的SCS技术可能降低了需要手术翻修的电极导线移位的发生率,尽管数据很少。本研究旨在回顾性评价永久植入10 kHz SCS系统的患者中具有临床意义的经皮电极导线移位的发生率。 分析纳入了2016年1月至2019年6月期间永久植入的慢性躯干和/或肢体疼痛的连续性患者。从医院的电子病历和制造商的数据库中收集数据。在6个月随访时,评估了具有临床意义的电极导线移位,定义为疼痛缓解减少,随后进行手术以纠正电极导线位置。 在6个月随访时,没有临床显著的电极导线移位病例,平均疼痛缓解率为65.2%,82%的患者有反应(疼痛缓解≥50%),72%的患者功能改善,42%的患者药物减少。随访12个月以上的患者疗效持续;平均疼痛缓解率为58.5%,有效率为82%。 目前使用的手术技术旨在最大限度地降低经皮电极导线移位的风险,并可能降低其发生率。此外,新的SCS系统可以提供更大的机会,使用替代刺激程序缓解轻微电极导线移动的情况。
Spinal cord stimulation (SCS) has been used over decades for pain management, but migration of percutaneous leads has been the most common complication. Better surgical techniques and newer SCS technologies likely reduced the incidence of lead migration requiring surgical revision, although data are sparse. This study aimed to retrospectively evaluate the incidence of clinically significant percutaneous lead migration in patients permanently implanted with a 10 kHz SCS system. Consecutive patients with chronic trunk and/or limb pain, permanently implanted between January 2016 and June 2019, were included in the analysis. Data were collected from the hospital's electronic medical records and the manufacturer's database. Clinically significant lead migration, defined as diminished pain relief followed by surgery to correct lead location, was assessed at the 6-month follow-up. At the 6-month follow-up, there were no cases of clinically significant lead migration, average pain relief was 65.2%, 82% of patients had response (≥50% pain relief), improvement of function was noted in 72% of patients, and decrease of medication was observed in 42% of patients. Therapy efficacy was sustained in patients with >12 months follow-up; the average pain relief was 58.5%, and the response rate was 82%. The surgical techniques in use today are designed to minimise the risk of percutaneous lead migration and may have reduced its incidence. In addition, new SCS systems may give greater opportunity to mitigate cases of minor lead movement using alternative stimulation programs.
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