Decreased Radiation Exposure with Percutaneous Shielded Lead Compared to Unshielded Implant for Spinal Cord Stimulation
|Nathalie Zaidman1, Brice Constant2, Cristo Chaskis1 and Laurence Abeloos1,2*|
|1Department of Neurosurgery, CHU Charleroi, Belgium|
|2Pain Clinic, CHU Charleroi, Belgium|
|Corresponding Author :||Laurence A
Department of Neurosurgery, CHU Charleroi
Chaussée de Bruxelles 140 6042 Charleroi, Belgium
E-mail: [email protected]
|Received November 11, 2014; Accepted December 22, 2014;; Published December 24, 2014|
|Citation:Zaidman N, Constant B, Chaskis C, Abeloos L (2014) Decreased Radiation Exposure with Percutaneous Shielded Lead Compared to Unshielded Implant for Spinal Cord Stimulation. J Pain Relief 3: 166. doi: 10.4172/2167-0846.1000166|
|Copyright: ©2014 Zaidman N, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.|
Background: Spinal cord stimulation (SCS) is a safe and effective treatment for refractory failed back surgery syndrome (FBSS). Two implantation procedures exist depending on the use of a surgical versus percutaneous lead. Percutaneous leads implantation is less invasive but the placement procedure requires a higher X-ray exposure. The new MRI compatible shielded percutaneous leads (Vectris®) appear to be stiffer and therefore seem to be easier to implant compared to unshielded percutaneous electrodes (Octad®). The aim of this study is to compare the radiation exposure between percutaneous shielded leads and percutaneous unshielded leads in SCS implantation.
Setting: Retrospective study.
Material and methods: 20 patients successively underwent SCS for FBSS. The first 10 patients were implanted with an Octad ® lead and the 10 following with a shielded Vectris ® lead. All patients were operated on by the same surgical team. In all cases, the same intra-operative X-rays device (Ziehm Vision 8000®) was used, with identical parameters aiming at a minimal X-rays exposure (pulse mode with 2 impulses/sec, and automatic mode for kVp and mAs).
Results: Fluoroscopy time was significantly lower in patients implanted with the Vectris® lead (mean: 99 seconds) compared to the Octad® lead (mean: 291 seconds) (p=0.0035). Subsequently, total patient X-rays exposure in the Vectris group (mean 592 cGycm2) was significantly lower than in the Octad® group (mean: 1899 cGycm2) (p=0.0005).
Conclusion: The use of MRI compatible shielded percutaneous leads significantly reduces the fluoroscopy time and the total X-ray exposure in SCS implantation.