• Thomas Simopoulos, Sanjiv Sharma, Moris Aner, and Jatinder S Gill.
• Department of Anesthesiology, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, U.S.A.
• Pain Pract. 2018 Sep 1; 18 (7): 845-849.

BackgroundLead fracture is a well-known complication of cylindrical spinal cord stimulator leads. In order to reduce this complication, anchor design and techniques have been modified, but internal lead design has received little attention.ObjectivesThe goal of this study was to study the impact of lead design by a retrospective determination of the fracture rate of multilumen concentric (MLC) 8-contact leads.Study DesignRetrospective chart review.SettingUniversity teaching hospital.MethodsA registry of spinal cord stimulator implants and corresponding billing data were used to identify patients. Procedural details were reviewed for technique, lead insertion, anchoring details, manufacturer, and lead longevity from 2002 to 2014. Data storage was in RedCap data-capturing software (REDCap eData Collection web-based application). All analyses were performed using SAS 9.3 (SAS Institute, Cary, NC, U.S.A.).ResultsIn a near 12"-year time period, 172 patients received 305 permanently implanted 8-contact leads, with an overall fracture rate of 4.3%. Of these, 191 leads were of the MLC design. No lead fracture was observed in the MLC leads over an average 4.5 years of follow-up.LimitationRetrospective single center.ConclusionMLC lead design has the potential to significantly mitigate lead fracture.© 2018 World Institute of Pain.

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