Türk Nöroşirürji Dergisi 2021 , Vol 31 , Num 3
Spinal Cord Stimulation: SCS by Laminectomy
Atilla YILMAZ1
1İstanbul Okan Üniversitesi, Beyin ve Sinir Cerrahisi Anabilim Dalı, İstanbul, Türkiye Spinal Cord Stimulation is a treatment intervention that has been used in the treatment of intractable pain since the 1960s. Although there is still debate about the mechanism of action, it has been shown by various studies that the electrical activity transmitted to the dorsal column of the spinal cord by an electrode causes some changes in the transmission/perception of pain and thus has very effective results in the treatment of pain.

There are two types of electrodes, which play a key role in transmitting electrical activity to the spinal cord: surgically placed paddle type and percutaneously placed cylindrical type. Both electrode types have their own advantages and disadvantages. While percutaneous electrodes have advantages such as being able to be placed under local anesthesia and getting feedback from the patient during the determination of the electrode level, surgical-type electrodes also have advantages such as lower migration risk, lower voltage requirement, and covering a wider area. However, while the surgical approach has disadvantages such as the necessity of general anesthesia, the necessity of laminectomy or laminotomy, and the need for incision and retraction of the muscles, percutaneous electrodes also have disadvantages such as higher migration and higher reoperation rates.

Considering all these advantages and disadvantages when deciding on the type of electrode to be selected in this treatment option which we apply as the third step in treatment-resistant pain, will increase the chances of success of the intervention. Anahtar Kelimeler : Spinal cord stimulation, Surgical type, Paddle type, Laminectomy