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Rates and Causes of Reoperations Following Spinal Cord Stimulation Within a 2-12 year Period.
Papadopoulos, Dimitrios V; Suk, Madeline S; Andreychik, David; Nikolaou, Vasileios; Haak, Michael.
Affiliation
  • Papadopoulos DV; Department of Orthopaedic Surgery, Geisinger Medical Center, Danville, PA, USA.
  • Suk MS; 2nd Academic Department of Orthopaedics, School of Medicine, Konstandopoulio General Hospital, National & Kapodistrian University of Athens, Athens, Greece.
  • Andreychik D; Department of Orthopaedic Surgery, Geisinger Medical Center, Danville, PA, USA.
  • Nikolaou V; Department of Orthopaedic Surgery, Geisinger Medical Center, Danville, PA, USA.
  • Haak M; 2nd Academic Department of Orthopaedics, School of Medicine, Konstandopoulio General Hospital, National & Kapodistrian University of Athens, Athens, Greece.
Global Spine J ; : 21925682231194466, 2023 Aug 05.
Article in En | MEDLINE | ID: mdl-37542526
ABSTRACT
STUDY

DESIGN:

Retrospective study.

OBJECTIVE:

Spinal cord stimulation has been mainly used for the management of postsurgical persistent neuropathic. The purpose of the study was to evaluate the rate and causes for reoperation following spinal cord stimulation, and to identify risk factors for reoperation.

METHODS:

A retrospective study was conducted including patients who underwent surgical implantation of spinal cord stimulators within a 10-year period. The medical records of the included patients were reviewed for reoperations, demographics and certain clinical parameters. Demographics and clinical parameters were compared between patients with and without reoperations, and between patients with and without surgical site infections.

RESULTS:

Overall, 1014 index procedures and 175 reoperations were performed within the study period. At least 1 reoperation was performed in 97 (9.5%) cases. The most common cause for revision was lead migration or lead misplacement (n = 31, 3.0%). In 31 (3.1%) cases the stimulator was removed due to no pain relief. Surgical site infection that required reoperation developed in 30 cases (2.9%). Younger age was associated with a need for reoperation (Odds Ratio [OR] .97,95% Confidence Interval [CI]0.95-.99, P = .005), while higher Body Mass index and diabetes were associated with development of infection (OR 1.05, 95% CI 1.00-1.11, P = .036 and OR 2.42, 95% CI 1.05-5.47, P = .033 respectively).

CONCLUSIONS:

The results of this study indicate that certain measures could improve the overall reoperation rate after spinal cord stimulation, such as accurate positioning of the spinal cord stimulators and design of smaller generators. Moreover, preoperative optimization of patients could result in lower complication rate, lower reoperations rate, and subsequently better clinical outcomes.
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Language: En Journal: Global Spine J Year: 2023 Document type: Article Affiliation country: United States

Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Language: En Journal: Global Spine J Year: 2023 Document type: Article Affiliation country: United States