Description
- Abstract:
- "Introduction: Epidural spinal cord stimulation (eSCS) and transcutaneous spinal cord stimulation (tSCS) for functional rehabilitation after spinal cord injury (SCI) have been researched over the last decade. While not approved for clinical use, eSCS and tSCS have shown to improve motor, cardiac, pulmonary, and genitourinary function. Overall safety of this intervention has not been systematically evaluated. This review aims to analyze complications related to tSCS and eSCS and identify trends. Methods:This review was executed according to PRISMA guidelines and includes 38 publications. Demographic, clinical, and complication data were extracted. All complications unrelated to laminectomy or device implantation were included. Between-study heterogeneity was assessed using I² statistics. Pearson correlation coefficients between demographics, stimulation parameters, and outcomes were calculated. Results:580 patients (mean age 40.0 years, mean time since SCI 7.5 years) were analyzed. Adverse events (AE) of any grade were observed in 26.7% (n=155) of patients, with none experiencing long-term AEs. Device site skin reactions, tingling, pain, and mild autonomic dysreflexia were most common. In eSCS, device malfunction or lead migration occurred in 1.38% (n=8) of patients, with 62% requiring surgical revision. 83.3% (5/6) instances of lead migration were in patients with percutaneous leads. For patients receiving tSCS, pain from stimulation was inversely related to age. No associations were found between sex, time since SCI, stimulator type, stimulation parameters (Hz, pulse width, amplitude) and complications. Conclusion: SCS is safe, but complications relating to prolonged device implantation and changes in functional autonomics remain common. Percutaneous lead migration was more frequent than paddle lead migration, consistent with prior literature. Pain during SCS may be reduced in older patients, potentially due to age-related demyelination or other confounders. Findings highlight the need for more robust safety profiling to isolate risks of eSCS and tSCS from complications relating to chronic SCI."
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Citation
Sugarmann, Lauren, Bosco, Alexa, Sternberg-Sher, Jacob , Fox, Stephen, Hasbrouck, Amanda, Mach, Alan, Paul, Leila, Fridley, Jared,
"Complications of Spinal Cord Stimulation in Patients With Chronic Spinal Cord Injury: A Systematic Review"
(2025).
Student Neurosurgery/Neurology Research Conference.
Brown Digital Repository. Brown University Library.
https://doi.org/10.26300/etkd-pv30
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Student Neurosurgery/Neurology Research Conference
Brown University Department of Neurosurgery and Department of Neurology and Warren Alpert Medical School annually hosts the Student Neurosurgery/Neurology Research Conference, a national conference for medical students conducting research in neurosurgery/neurology or related neuroscience fields....