The Incidence of Spinal Cord Injury in Implantation of Percutaneous and Paddle Electrodes for Spinal Cord Stimulation.
The Incidence of Spinal Cord Injury in Implantation of Percutaneous and Paddle Electrodes for Spinal Cord Stimulation.
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DOI：
10.1111/ner.12370
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发表时间：
2016-01
期刊：
影响因子：
--
通讯作者：
Lad SP
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文献类型：
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作者：
Petraglia FW 3rd;Farber SH;Gramer R;Verla T;Wang F;Thomas S;Parente B;Lad SP
脊髓刺激（SCS）已被证明对多种慢性疼痛综合征有效。在过去40年的使用中，文献中已明确定义了SCS的并发症发生率;然而，最具破坏性的并发症之一脊髓损伤（SCI）的发生率在很大程度上仍然未知。本研究的目的是量化经皮和桨状电极植入中SCI的发生率。我们对Thomson罗伊特MarketScan数据库中2000年至2009年接受经皮或桨式SCS植入术的所有患者进行了回顾性审查。研究的主要结局指标是术后30天内SCI和脊髓血肿的发生率。共有8，326例患者符合研究的入选标准（经皮穿刺5，458例与桨式导管：2，868例）。SCI的总体发生率为177（2.13%）（经皮：128（2.35%）vs.桨：49（1.71%），p=0.0556）。脊髓血肿的总体发生率为59（0.71%）（经皮：41（0.75%）vs.桨：18（0.63%），p = 0.5230）。我们的研究表明，SCS中SCI的总体发生率较低（2.13%），支持SCS是一种安全手术。经皮和桨组之间的SCI或脊髓血肿发生率无显著差异。需要进一步的研究来描述SCS中SCI的机制和这些患者的长期结局。
Spinal cord stimulation (SCS) has been proven effective for multiple chronic pain syndromes. Over the past 40 years of use, the complication rates of SCS have been well defined in the literature; however, the incidence of one of the most devastating complications, spinal cord injury (SCI), remains largely unknown. The goal of the study was to quantify the incidence of SCI in both percutaneous and paddle electrode implantation. We conducted a retrospective review of the Thomson Reuter's MarketScan database of all patients that underwent percutaneous or paddle SCS implantation from 2000 to 2009. The main outcome measures of the study were the incidence of SCI and spinal hematoma within 30 days following operation. Overall 8,326 patients met inclusion criteria for the study (percutaneous 5,458 vs. paddle: 2,868). The overall incidence of SCI was 177 (2.13%) (percutaneous: 128 (2.35%) vs. paddle: 49 (1.71%), p=0.0556). The overall incidence of spinal hematoma was 59 (0.71%) (percutaneous: 41 (0.75%) vs. paddle: 18 (0.63%), p = 0.5230). Our study shows the overall incidence of SCI in SCS is low (2.13%) supporting that SCS is a safe procedure. No significant difference was found in the rates of SCI or spinal hematoma between the percutaneous and paddle groups. Further studies are needed to characterize the mechanisms of SCI in SCS and long-term outcomes in these patients.