INTRODUCTION: Patients will typically undergo awake surgery for permanent implantation of spinal cord stimulation (SCS) in an attempt to optimize electrode placement using patient feedback about the distribution of stimulation-induced paresthesia. The present study compared efficacy of first-time electrode placement under awake conditions with that of neurophysiologically guided placement under general anesthesia. METHODS: A retrospective review was performed of 387 SCS surgeries among 259 patients which included 167 new stimulator implantation to determine whether first time awake surgery for placement of spinal cord stimulators is preferable to non-awake placement. RESULTS: The incidence of device failure for patients implanted using neurophysiologically guided placement under general anesthesia was one-half that for patients implanted awake (14.94% vs. 29.7%). CONCLUSION: Non-awake surgery is associated with fewer failure rates and therefore fewer re-operations, making it a viable alternative. Any benefits of awake implantation should carefully be considered in the future.
INTRODUCTION: Patients will typically undergo awake surgery for permanent implantation of spinal cord stimulation (SCS) in an attempt to optimize electrode placement using patient feedback about the distribution of stimulation-induced paresthesia. The present study compared efficacy of first-time electrode placement under awake conditions with that of neurophysiologically guided placement under general anesthesia. METHODS: A retrospective review was performed of 387 SCS surgeries among 259 patients which included 167 new stimulator implantation to determine whether first time awake surgery for placement of spinal cord stimulators is preferable to non-awake placement. RESULTS: The incidence of device failure for patients implanted using neurophysiologically guided placement under general anesthesia was one-half that for patients implanted awake (14.94% vs. 29.7%). CONCLUSION: Non-awake surgery is associated with fewer failure rates and therefore fewer re-operations, making it a viable alternative. Any benefits of awake implantation should carefully be considered in the future.
Authors: Brian Fiani; Taylor Reardon; Jacob Selvage; Alden Dahan; Mohamed H El-Farra; Philine Endres; Taha Taka; Yasmine Suliman; Alexander Rose Journal: Surg Neurol Int Date: 2021-05-10
Authors: Philippe Rigoard; Amine Ounajim; Lisa Goudman; Chantal Wood; Manuel Roulaud; Philippe Page; Bertille Lorgeoux; Sandrine Baron; Kevin Nivole; Mathilde Many; Emmanuel Cuny; Jimmy Voirin; Denys Fontaine; Sylvie Raoul; Patrick Mertens; Philippe Peruzzi; François Caire; Nadia Buisset; Romain David; Maarten Moens; Maxime Billot Journal: J Clin Med Date: 2022-09-22 Impact factor: 4.964