Spinal Cord Stimulation With a Dual Quadripolar Surgical Lead Placed in General Anesthesia Is Effective in Treating Intractable Low Back and Leg Pain

Abstract

Objectives. Spinal cord stimulation has been used extensively for failed back surgery syndrome, although dominant axial low back pain is difficult to treat effectively with this modality. The use of a surgically placed, double, quadripolar lead may result in better paresthesia of the low back, therefore enhancing outcomes in this difficult to treat population.

Materials and Methods. Accordingly, this prospective study was designed to assess the effectiveness of placing such a lead at the T8–T10 level under general anesthesia without intraoperative testing for concordancy of paresthesia distribution.

Results. The study showed that 70% of patients had "good" or "complete" long-term pain relief after placement of a surgically placed dual quadripolar lead under general anesthesia and analgesic consumption decreased significantly. The ability to lead a more active and social life was increased and 85% of patients said they would undergo spinal cord stimulation again. Placing the lead higher in the spinal canal (T8) resulted in a tendency for better paresthesia coverage of the low back when compared to lower lead placements.

Conclusions. Placing a double quadripolar paddle lead under general anesthesia resulted in good clinical outcome similar to other implant techniques.