BACKGROUND: Spinal cord stimulation (SCS) involves the placement of percutaneously placed cylindrical leads or surgically placed paddle leads to deliver electrical stimulation for pain relief. Although more invasive, paddle leads have been associated with less lead migration and revision. We performed a retrospective review of a prospective database of SCS paddle lead implants performed by a single neurosurgeon.

CASE SERIES: Patients were contacted to complete a telephone questionnaire assessing postoperative outcomes. We identified n = 10 patients who underwent replacement of percutaneous SCS with paddle lead SCS. Six patients responded to the questionnaire after an average follow-up period of 37.67 ± 12.72 months. At long-term follow-up, 3/6 respondents reported significant pain relief, and 5/6 respondents reported a decreased need for pain medication.

CONCLUSIONS: Comparative outcome data on percutaneous vs paddle lead SCS is limited. Our experience has been that patients who fail percutaneous SCS may be salvaged with conversion to paddle leads with good outcomes.

KEYWORDS: Neuromodulation, chronic pain, failed back surgery syndrome, neuropathic pain, revision surgery, spinal cord stimulation