Biplane fluoroscopy-guided percutaneous spinal cord stimulation

Abstract

ObjectiveFluoroscopy is useful for spinal cord stimulation (SCS) lead placement. We employed biplane fluoroscopy for SCS lead placement. In this study, we sought to confirm the validity of using biplane fluoroscopy for SCS lead placement and to establish whether biplane fluoroscopy safely reduces the duration of surgery. MethodsClinical data were retrospectively collected from the medical records of patients who underwent SCS lead placement under local anesthesia from 2015 to 2022. The duration of the surgical phase and the total radiation exposure time per case were recorded. ResultsForty-six patients underwent percutaneous SCS lead implantation. Recording was completed in 41 cases: one lead was placed in 13 cases and two leads were placed in 28 cases. Monoplane and biplane fluoroscopy was used in 15 and 26 patients, respectively. Although the type of fluoroscopy did not significantly affect the mean duration of the surgical phase in patients in which one lead was placed, biplane fluoroscopy was associated with a significant reduction in the mean duration of the surgical phase in patients that underwent placement of two leads (P=0.002). No significant differences in the total radiation exposure time were observed between patients in the monoplane and biplane fluoroscopy groups that were implanted with one (P=0.21) or two leads (P=0.62). ConclusionsThe use of biplane fluoroscopy reduced the duration of surgery necessary for the placement of two SCS leads. Biplane fluoroscopy represents a practical and safe adjustment to the current practice of SCS lead implantation.