Long-Term Follow-Up of Paddle Lead Cervical Spinal Cord Stimulation for Failed Neck Surgery SyndromeNestor Denys Tomycz, MD1, Srinivas Chivikula, BS1, John Moossy, MD11Pittsburgh, PA United States Keywords: pain, electrical stimulation, cervical spine, complications, spinal cordInteractive Manuscript
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What is the background behind your study?
What is the purpose of your study?
Failed neck surgery syndrome (FNSS) describes patients with intractable chronic neck and/or upper extremity pain despite surgery for cervical degenerative disease.
Describe your patient group.
Six of 8 patients (75%) underwent permanent paddle lead and pulse generator implantation.
Describe what you did.
We identified 8 patients with FNSS that underwent a trial of paddle cervical SCS for FNSS by a single neurosurgeon. Follow-up was obtained via telephone interviews and the mean follow-up was 6.2 years.
Describe your main findings.
The mean reduction in pain for patients undergoing implantation was 55.2% (50-70%). All 6 patients were initially satisfied with cervical SCS and reported a mean duration of satisfactory pain relief of 2.0 years (0.5-3.0 years). Moreover, during this period of pain relief, all 6 patients claimed that cervical SCS improved their quality of life and 5 patients (83.3%) reported that their pain medication requirements decreased due to successful cervical SCS. However, at a mean follow-up of 6.2 years, only 1 patient continues to use the SCS for pain control. Four patients described a loss of efficacy after initial satisfactory pain relief and 1 patient had the SCS system explanted in the setting of fevers of unknown origin. Four of 6 patients (66.7%) said they would undergo cervical SCS again.
Describe the main limitation of this study.
This is a retrospective study.
Describe your main conclusion.
Paddle lead cervical SCS appears to be able to provide certain patients with FNSS improved quality of life and significant pain relief.
Describe the importance of your findings and how they can be used by others.
We feel that cervical SCS has a role in FNSS patients however technological advances are needed to improve the disappointing long-term pain relief in this patient population.
Failed neck surgery syndrome (FNSS) describes patients with intractable chronic neck and/or upper extremity pain despite surgery for cervical degenerative disease.
Six of 8 patients (75%) underwent permanent paddle lead and pulse generator implantation.
We identified 8 patients with FNSS that underwent a trial of paddle cervical SCS for FNSS by a single neurosurgeon. Follow-up was obtained via telephone interviews and the mean follow-up was 6.2 years.
The mean reduction in pain for patients undergoing implantation was 55.2% (50-70%). All 6 patients were initially satisfied with cervical SCS and reported a mean duration of satisfactory pain relief of 2.0 years (0.5-3.0 years). Moreover, during this period of pain relief, all 6 patients claimed that cervical SCS improved their quality of life and 5 patients (83.3%) reported that their pain medication requirements decreased due to successful cervical SCS. However, at a mean follow-up of 6.2 years, only 1 patient continues to use the SCS for pain control. Four patients described a loss of efficacy after initial satisfactory pain relief and 1 patient had the SCS system explanted in the setting of fevers of unknown origin. Four of 6 patients (66.7%) said they would undergo cervical SCS again.
This is a retrospective study.
Paddle lead cervical SCS appears to be able to provide certain patients with FNSS improved quality of life and significant pain relief.
We feel that cervical SCS has a role in FNSS patients however technological advances are needed to improve the disappointing long-term pain relief in this patient population.
Project Roles:
N. Tomycz (), S. Chivikula (), J. Moossy ()
