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Stimulation of the Spinal Cord by the Placement of Surgical Based Paddle Leads

  • Timothy R. Deer
  • Robert M. Levy
  • Claudio A. Feler
Chapter

Abstract

Spinal cord stimulation can be achieved by placing a needle into the epidural space and then passing a cylindrical lead into the proper place in the posterior section of that space to modulate the neurological function of the neuroaxis. This percutaneous method is favored by the majority of implanters and is the common method of doing trials and most permanent implants. The alternative method of placing a spinal cord stimulation lead is by an open surgical technique in which a small laminectomy is performed to allow a ribbon-type surgical or paddle lead to be placed in an antegrade or retrograde fashion. The paddle or plate lead allows for a more efficient, unidirectional, stable lead that has a different characteristic of stimulation than the percutaneous lead. Paddle leads are indicated based on surgeon preference or other clinical factors detailed in Table 10.1.

Keywords

Epidural Space Spinal Cord Stimulation Epidural Abscess Lead Placement Posterior Section 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Suggested Reading

  1. Falowski S, Celii A, Sharan A. Spinal cord stimulation: an update. Neurotherapeutics. 2008;5:86–99.PubMedCrossRefGoogle Scholar
  2. North R, Olin KD, Sieracki J. Spinal cord stimulation electrode design: prospective, randomized, controlled trial comparing percutaneous and laminectomy electrodes-part i: technical outcomes. Neurosurgery. 2002;51(2):381–390.PubMedGoogle Scholar
  3. Buvanendran A, Lubenow T. Efficacy of transverse tripolar spinal cord stimulator for the relief of chronic low back pain from failed back surgery. Pain Phys. 2008;11(3):333–338.Google Scholar
  4. Oakley J, Prager J. Spinal cord stimulation: mechanisms of action. Spine. 2002;27(22):2574–2583.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Timothy R. Deer
    • 1
  • Robert M. Levy
  • Claudio A. Feler
  1. 1.Center for Pain ReliefCharlestonUSA

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