Novel Technique for Insertion of Cervical Spinal Cord Stimulator Percutaneous Leads: Technical Note and Institutional Experience.

OBJECTIVE: Cervical spinal cord stimulation is a safe and effective treatment for chronic axial neck pain and upper limb neuropathic pain. We report our novel institutional experience with performing cervical spinal cord stimulation trials with patients placed in an upright sitting position. This allows easy access to the cervical epidural space and has the added benefit of unobstructed access to the airway.

METHODS: We retrospectively reviewed data for patients who had undergone cervical spinal cord stimulation trial procedures in an upright, sitting position at the Vanderbilt University Medical Center. Demographic information including age, gender, preoperative diagnosis, progression to permanent implant after a successful trial, and operative time in minutes was collected.

RESULTS: A detailed description of the technique for implantation of cervical spinal cord stimulator trial leads in an upright sitting position is described. A total of 29 patients were implanted; 16 (55%) were female. Mean operative time was 78 minutes from incision to closing. The majority of patients (25/29; 86%) had successful trials and proceeded to permanent implant. No complications occurred, and the procedure was well tolerated by all patients.

CONCLUSIONS: Cervical spinal cord stimulation trials performed in an upright, sitting position allow for easy epidural access and an unobstructed airway with reasonable setup time.