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Comparison of Clinical Efficacy and Computed Tomographic Analysis of Lead Position Between Three-Column and Five-Column Paddle Leads Spinal Cord Stimulation for Failed Back Surgery Syndrome.
World Neurosurg. 2017 Jan; 97:292-303.WN

Abstract

OBJECTIVE

To investigate the difference in clinical outcome and the position of paddle lead spinal cord stimulation (SCS) between 3-column and 5-column paddle lead SCS in patients with failed back surgery syndrome.

METHODS

In 21 patients who underwent paddle lead SCS at T9 (3-column, n = 9; 5-column, n =12) for failed back surgery syndrome, a 12-month follow-up numerical rating scale, percent pain relief, and computed tomography assessment of contact angle and percent reduction of T9 canal area were investigated.

RESULTS

There was no difference in paresthesia coverage of the painful area, trial success rate, clinical outcomes, and percent pain relief between the 2 groups (P >0.05). The contact angle in the 5-column group was generally more than that of the 3-column group (P = 0.067). Overall reduction of 35.51% ± 4.76% in the T9 canal was observed and there was no difference between the 2 groups (P >0.05) and no correlation between the contact angle and percent T9 spinal canal reduction (r = -0.247, P > 0.05).

CONCLUSIONS

Although clinical efficacy of SCS using three-column and five-column paddle lead was not significant different from each other, significant inclination of paddle lead in posterior epidural space with significant reduction in T9 canal area were observed in both groups. The degree of inclination in the 5-column group was more than that in the 3-column lead group. Close approximation of paddle lead contacts to dorsal spinal cord with reduced dorsal cerebrospinal fluid space and intraoperative neurophysiologic guidance might have contributed to the high rate of trial success and long-term pain control.

Authors+Show Affiliations

Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.Department of Neurosurgery, Chosun University Hospital, Chosun University, Gwangju, Republic of Korea.Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; The Catholic Neuroscience Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address: sbc@catholic.ac.kr.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

27744081

Citation

Choi, Jin-Gyu, et al. "Comparison of Clinical Efficacy and Computed Tomographic Analysis of Lead Position Between Three-Column and Five-Column Paddle Leads Spinal Cord Stimulation for Failed Back Surgery Syndrome." World Neurosurgery, vol. 97, 2017, pp. 292-303.
Choi JG, Ha SW, Son BC. Comparison of Clinical Efficacy and Computed Tomographic Analysis of Lead Position Between Three-Column and Five-Column Paddle Leads Spinal Cord Stimulation for Failed Back Surgery Syndrome. World Neurosurg. 2017;97:292-303.
Choi, J. G., Ha, S. W., & Son, B. C. (2017). Comparison of Clinical Efficacy and Computed Tomographic Analysis of Lead Position Between Three-Column and Five-Column Paddle Leads Spinal Cord Stimulation for Failed Back Surgery Syndrome. World Neurosurgery, 97, 292-303. https://doi.org/10.1016/j.wneu.2016.10.012
Choi JG, Ha SW, Son BC. Comparison of Clinical Efficacy and Computed Tomographic Analysis of Lead Position Between Three-Column and Five-Column Paddle Leads Spinal Cord Stimulation for Failed Back Surgery Syndrome. World Neurosurg. 2017;97:292-303. PubMed PMID: 27744081.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of Clinical Efficacy and Computed Tomographic Analysis of Lead Position Between Three-Column and Five-Column Paddle Leads Spinal Cord Stimulation for Failed Back Surgery Syndrome. AU - Choi,Jin-Gyu, AU - Ha,Sang-Woo, AU - Son,Byung-Chul, Y1 - 2016/10/12/ PY - 2016/07/23/received PY - 2016/10/01/revised PY - 2016/10/04/accepted PY - 2016/10/17/pubmed PY - 2017/9/19/medline PY - 2016/10/17/entrez KW - Computed tomography KW - Failed back surgery syndrome KW - Paddle lead KW - Spinal cord stimulation SP - 292 EP - 303 JF - World neurosurgery JO - World Neurosurg VL - 97 N2 - OBJECTIVE: To investigate the difference in clinical outcome and the position of paddle lead spinal cord stimulation (SCS) between 3-column and 5-column paddle lead SCS in patients with failed back surgery syndrome. METHODS: In 21 patients who underwent paddle lead SCS at T9 (3-column, n = 9; 5-column, n =12) for failed back surgery syndrome, a 12-month follow-up numerical rating scale, percent pain relief, and computed tomography assessment of contact angle and percent reduction of T9 canal area were investigated. RESULTS: There was no difference in paresthesia coverage of the painful area, trial success rate, clinical outcomes, and percent pain relief between the 2 groups (P >0.05). The contact angle in the 5-column group was generally more than that of the 3-column group (P = 0.067). Overall reduction of 35.51% ± 4.76% in the T9 canal was observed and there was no difference between the 2 groups (P >0.05) and no correlation between the contact angle and percent T9 spinal canal reduction (r = -0.247, P > 0.05). CONCLUSIONS: Although clinical efficacy of SCS using three-column and five-column paddle lead was not significant different from each other, significant inclination of paddle lead in posterior epidural space with significant reduction in T9 canal area were observed in both groups. The degree of inclination in the 5-column group was more than that in the 3-column lead group. Close approximation of paddle lead contacts to dorsal spinal cord with reduced dorsal cerebrospinal fluid space and intraoperative neurophysiologic guidance might have contributed to the high rate of trial success and long-term pain control. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/27744081/Comparison_of_Clinical_Efficacy_and_Computed_Tomographic_Analysis_of_Lead_Position_Between_Three_Column_and_Five_Column_Paddle_Leads_Spinal_Cord_Stimulation_for_Failed_Back_Surgery_Syndrome_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1878-8750(16)30999-8 DB - PRIME DP - Unbound Medicine ER -