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Cranial Plate Anchoring of Spinal Cord Stimulation Paddle Leads: Technical Note
Journal article   Peer reviewed

Cranial Plate Anchoring of Spinal Cord Stimulation Paddle Leads: Technical Note

Nestor D. Tomycz, Jeffrey Cameron, Donald M. Whiting and Michael Y. Oh
Neurosurgery, v 71(1)
01 Sep 2012
PMID: 22157546

Abstract

Clinical Neurology Life Sciences & Biomedicine Neurosciences & Neurology Science & Technology Surgery
BACKGROUND: Lead migration is a frequent complication of spinal cord stimulation (SCS) and requires revision surgery. The evolution of wider paddle leads has necessitated more extensive laminotomy and epidural adhesiolysis, which may increase the risk of lead migration. OBJECTIVE: We describe a novel anchoring technique for SCS paddle leads with use of a cranial "dogbone" plate. METHODS: We retrospectively reviewed a consecutive series of 11 patients who underwent placement of paddle lead spinal cord stimulators with titanium plate anchoring. Patients were followed for a mean of 29.5 months from SCS implantation (range, 5-65 months). A 4-hole linear titanium cranial plate and two 4-mm screws were used to tightly affix the proximal paddle lead wiring to the lamina below the laminotomy defect. RESULTS: All patients continue to have satisfactory spinal cord stimulation with no loss of efficacy or need for revision. No complications have been attributed to titanium plate anchoring, and there have been no cases of lead migration with this technique. Titanium plate anchoring added minimal time (approximately 3-5 minutes) to the operative case. CONCLUSION: We report a safe and effective anchoring technique for paddle lead SCS with the use of a cranial plate. Our experience has been that this technique, which anchors the proximal lead wiring to the remaining lamina at the inferior laminotomy defect, is superior to anchoring methods that rely on suturing of lead wiring.

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Web of Science research areas
Clinical Neurology
Surgery
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