Comparative Study Show
. 2013 Sep-Oct;16(5):418-26; discussion 426-7. doi: 10.1111/ner.12065. Epub 2013 May 3. Affiliations
Comparative Study Outcomes of percutaneous and paddle lead implantation for spinal cord stimulation: a comparative analysis of complications, reoperation rates, and health-care costsRanjith Babu et al. Neuromodulation. 2013 Sep-Oct. AbstractObjectives: Spinal cord stimulation (SCS) is a well-established modality for the treatment of chronic pain, and can utilize percutaneous or paddle leads. While percutaneous leads are less invasive, they have been shown to have higher lead migration rates. In this study, we compared the long-term outcomes and health-care costs associated with paddle and percutaneous lead implantation. Materials and methods: We utilized the MarketScan data base to examine patients who underwent percutaneous or paddle lead SCS system implantation from 2000 to 2009. Outcomes including complications, reoperation rates, and health-care costs were evaluated in propensity score matched cohorts using univariate and multivariate analyses. Results: The study cohort was comprised of 13,774 patients. At 90 days following the initial procedure, patients in the SCS paddle group were more likely to develop a postoperative complication than patients receiving percutaneous systems (3.4% vs. 2.2%, p = 0.0005). Two-year (6.3% vs. 3.5%, p = 0.0056) and long-term (five+ years) (22.9% vs. 8.5%, p < 0.0008) reoperation rates were significantly higher in those with percutaneous lead systems. However, long-term health-care costs were similar for those receiving paddle and percutaneous leads ($169,768 vs. $186,139, p = 0.30). Conclusions: While the implantation of paddle leads is associated with slightly higher initial postoperative complications, these leads are associated with significantly lower long-term reoperation rates. Nonetheless, long-term health-care costs are similar between paddle and percutaneous leads. Additional improvements in SCS technologies that address the shortcomings of current systems are needed to reduce the risk of reoperation due to hardware failure. Further study is required to evaluate the efficacy of newer percutaneous and paddle SCS systems and examine their comparative outcomes. Keywords: Health-care cost; paddle lead; percutaneous lead; reoperation; spinal cord stimulation. © 2013 International Neuromodulation Society. Similar articles
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What are the different types of spinal cord stimulators?Spinal cord stimulators come in 3 main types:. Conventional implantable pulse generator, or IPG. A battery is placed in the spine during an operation. ... . Rechargeable implantable pulse generator. A battery is placed in the spine during an operation. ... . Radiofrequency stimulator. This type of stimulator is an older design.. What is the newest spinal cord stimulator?FDA approves Medtronic's long-lasting Vanta spinal cord stimulator | Fierce Biotech.
What is a spinal paddle?Spinal cord stimulation (also called SCS) uses electrical impulses to relieve chronic pain of the back, arms and legs. It is believed that electrical pulses prevent pain signals from being received by the brain.
What is a stimulator lead?Electrodes at the end of the lead produce electrical pulses that stimulate the nerves, blocking pain signals. The patient gives feedback to help the physician determine where to place the stimulators to best block the patient's pain.
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Spinal cord stimulator paddles vs leads
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