• Anton Früh, Tarik Alp Sargut, Melanie Brüßeler, Laura Hallek, Anja Kuckuck, Peter Vajkoczy, and Simon Bayerl.
• Department of Neurosurgery, Charité - Universitätsmedizin Berlin, Berlin, Germany; BIH Biomedical Innovation Academy, BIH Charité Junior Digital Clinician Scientist Program, Charitéplatz 1, 10117, Berlin, Germany.
• World Neurosurg. 2024 Oct 10.

ObjectivePersistent spinal pain syndrome (PSPS) poses a significant medical challenge, often leading to diminished quality of life for affected individuals. In response to this clinical dilemma, Spinal Cord Stimulation (SCS) has emerged as a promising intervention aimed at improving the functional outcomes and overall well-being of patients suffering from these debilitating syndrome. In case a therapy with percutaneous lead fails, e.g. due to a dislocation, surgical lead can be used as a stable alternative. This is resulting in a more invasive procedure and does not allow for intraoperative monitoring. The aim of the study is to investigate the efficacy and safety of the use of surgical leads, as there have been only a few case series published so far.MethodsWe included PSPS patients that gave consent to a SCS therapy and were treated with Surgical Leads. Outcome scores concerning the quality of life (SF-36), pain related disability (Oswestry disability index [ODI]), sleeping quality (Pittsburgh Sleep Quality Index [PSQI]), and pain intensity (NRS) were obtained prior surgery and at outpatient visits after permanent implantation.ResultsIn this study, 36 patients were implanted with a Surgical Lead SCS system. One patient developed a new neurological deficit characterized by left-sided leg paresis attributable to postoperative hemorrhage, and another patient experienced a wound infection. These complications contributed to an overall morbidity rate of 5.6%. In overall 5 patients (20.8%) the electrodes were explanted within the first month. Follow-up data of 24 subjects with a median time of 21 [15-47] months were available. The mean pain intensity at rest and in motion was reduced. Further pain depending disability improved from a median ODIpreop=38 [30-57]% to ODIfollow-up =21 [9-35]% (p<0.01). Additionally the Sleeping Quality and the Quality of Life improved concerning the physical (Median PCS preop=22.5 [20.4-30.4] vs. PCSfollow-up = 41.8 [35.2-47.0], p < 0.01).) and mental (Median MCSpreop=45.4 [31.1-55.5] vs. MCSfollow-up=58.1 [47.6-59.8], p=0.018). component.ConclusionSCS with surgical leads is a safe secondary technique to treat PSPS, where treatment with percutaneous leads fail. The results show a promising long-term effect concerning pain intensity and functional outcome.Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.

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