• Taylor W Sommer, Sven Ivankovic, and Todd D McCall.
• Department of Neurosurgery, University of Illinois College of Medicine at Peoria, Peoria, Illinois, USA. Electronic address: taylor.sommer@osfhealthcare.org.
• World Neurosurg. 2023 Feb 1; 170: e712e715e712-e715.

ObjectiveSpinal cord stimulators (SCS) represent an effective treatment for patients with chronic pain issues. This study examines extremely obese patients (body mass index [BMI] ≥40) as appropriate surgical candidates for paddle lead SCS trial via partial thoracic laminectomy and whether obesity impacts implantation safety.MethodsA retrospective review of patients treated with partial thoracic laminectomy and paddle lead SCS trial between October 1, 2016 and September 30, 2019 was performed. The primary outcome was implantation safety (complication rate within minimum of 90 days) in patients with extreme obesity (BMI ≥40) compared with patients with BMI <40 and secondary outcome was effectiveness (successful trial leading to final implantation). Seventy-three patients underwent SCS trial.ResultsFour (5.48%) patients developed complications with only 1 patient in the BMI ≥40 cohort (not statistically significant). Overall trial success rate was 82.2% (60/73) with statistically significant higher success rates among patients with a BMI ≥40 (93.3% vs. 74.4%, P = 0.0183).ConclusionsWe conclude that paddle lead SCS trial in extremely obese patients is reasonable to offer with the expectation of similar safety concerns as those for patients with a lower BMI.Copyright © 2022 Elsevier Inc. All rights reserved.

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