Spinal cord stimulator scar6/14/2023 ![]() Minimally invasive spine surgery (MISS) has been found to reduce surgical-related morbidity by decreasing tissue damage, blood loss, and reduced pain relative to open approaches. Comparative studies have provided inconclusive evidence to support a superior modality, but surgical implantations of paddle leads are more common and the relevant approach for this technical note. Notably, the implantation of SCS is reported to have a low incidence of life-threatening complications in both percutaneous and surgical implantation. SCS implantation techniques are broadly categorized into two categories: percutaneous and paddle lead implantation. There exists an opportunity to ameliorate paddle lead migration through technical modifications. This parallels a review of the literature on the complications of SCS that identified hardware-related complications as more common than biological complications, of which lead migration was most common. The incidence of technical failures and procedural complications in 68 studies of more than 2700 patients reported a lead migration incidence of 13.2%, well ahead of 9.1% for lead breakage as the second most common. ![]() Descriptive studies report complication rates between 5.3% to 40% and are dominated by sporadic case reports of unique failure modes. There are high levels of evidence to support SCS indications , but there is a paucity of literature rigorously characterizing risks and complications. Spinal Cord Stimulators (SCS) are a nonpharmacologic chronic pain management treatment modality within the surgeon’s armamentarium that is well-validated and is cost-effective.
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