• Rebecca A Sanders, Bryan C Hoelzer, Markus A Bendel, Tim J Lamer, Thomas P Pittelkow, Jason S Eldrige, Matthew J Pingree, Susan M Moeschler, Halena M Gazelka, W David Mauck, and Richard H Rho.
• Department of Anesthesiology and Pain Medicine, Mayo Clinic, Rochester, Minnesota, U.S.A.
• Pain Pract. 2018 Jun 1; 18 (5): 562-567.

ObjectiveThe goal of this study was to determine the frequency and clinical indications associated with implantation of single vs. dual percutaneous lead spinal cord stimulator (SCS) systems and to look further into how these leads are utilized for treatment.Materials And MethodsA retrospective cohort analysis of all patients undergoing SCS implantation between January 2001 and December 2013 with a minimum of 2 years of clinical follow-up was performed. Number of trial leads and implanted leads was recorded. For patients with dual-lead systems, it was noted if and when the second lead was used, along with the clinical indication for lead activation.ResultsIn the 259-patient cohort, 15.8% (n = 41) patients underwent placement of a single-lead system, 83.0% (n = 215) underwent placement of a dual-lead system, and 1.2% (n = 3) underwent placement of 3-lead systems. Placement of dual-lead systems was similar among all indication groups. Of those patients with a dual-lead system in place, 88.1% utilized both leads and average time to programming of the second lead was 2.3 months. The most common reason to activate the second lead was inadequate stimulation coverage. Five of the 41 patients with single-lead systems underwent an additional surgery to implant a second lead due to inadequate stimulation with 1 lead.ConclusionsTo our knowledge this is the first descriptive analysis of the frequency of single- and dual-lead SCS systems. This report indicates that dual-lead systems are most often placed and both leads are required for optimal patient therapy.© 2017 World Institute of Pain.

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