Intraoperative monitoring may help ensure proper placement of spinal cord stimulation leads

WASHINGTON — Intraoperative neurophysiological monitoring can help verify accurate placement of the leads used during spinal cord stimulation, according to a presenter at the American Association of Neurological Surgeons Annual Meeting.

“Our data suggest intraoperative neurophysiological testing is a viable method of verifying [spinal cord stimulation] SCS lead placement,” Steven G. Roth, MS, a third-year medical student at Albany Medical College, said here. “EMG [electromyography] may help to streamline the programming processes by predicting the ideal contacts in many cases.”

Roth and colleagues prospectively studied 73 patients who received SCS for standard indications. Implantation was performed under general anesthesia, and EMG and somatosensory-evoked potential (SSEP) collision studies were used to verify the lead placement.

At 6-month follow-up, the researchers interrogated each of the patients’ implants to determine its usage data, Roth said. Overall, 58 patients with complete datasets were available for analysis. The researchers compared the intraoperative neurophysiological monitoring with the contacts to determine the greatest use in pain relief.

Roth and colleagues found that with EMG, the patients lateralized the lead with an 86.7% success rate. Using SSEP collision studies, patients lateralized the lead with a 64% success rate. The leads had a 30% reposition rate, according to the researchers. – by Kristine Houck, MA, ELS

Reference:
Roth SG, et al. Paper #719. Presented at: American Association of Neurological Surgeons Annual Meeting. May 2-6, 2015; Washington, D.C.

Disclosure: Roth reports no relevant financial disclosures.