Long-term Follow-up of Patients Implanted with a 5-Column Paddle Electrode for Neuropathic Pain

Chengyuan Wu, MD1, Ashwini Sharan, MD1

1Philadelphia, PA United States

Keywords: nerve, pain, electrical stimulation, outcome, neuropathic pain

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     Spinal cord stimulation (SCS) is often employed for the treatment of neuropathic pain. The 5-column electrode has improved our ability to cover complex distributions of pain - largely in part to electrode configuration and greater programming flexibility.
     Introduced December 2009, limited long-term data for this electrode is available.
     Sixteen patients underwent implantation at our institution between June 2010 to June 2011.
     This retrospective cohort study included patients implanted with a 5-column electrode (St. Jude Medical). Sixteen patients underwent implantation at our institution between June 2010 to June 2011. Both patient information and specific system data were gathered for each patient. Patients were contacted to assess their satisfaction, Owestry Disability Index, Visual Analogue Scale, and pain coverage percentage.
     Patients were followed for an average of 293 + 120 days (83 to 468 days). 68.8% were satisfied with their SCS system. There was a 50-90% reduction of pain with 70-100% coverage of the area of pain. Of the five patients not satisfied with SCS, four were placed during the first three months of device availability. Two ultimately had their system explanted, one underwent revision, and two sought other modes of treatment.
     This is a retrospective study.
     Early experience with the 5-column SCS electrode has been promising. Longer-term data presented here is comparable to a prior series demonstrating 81.8% patient satisfaction. In addition, the temporal distribution of patient satisfaction suggests a possible improvement in surgical technique or patient selection. Satisfaction was independent of pain distribution and electrode location.
     Higher patient satisfaction compared to 50-60% reported for SCS to date is likely due to greater flexibility offered by the 5-column electrode.


Project Roles:

C. Wu (), A. Sharan ()