Paddle lead

Thoracic radiculopathy has been reported as a complication of spinal cord stimulation (SCS) paddle lead implantation by several authors and commonly presents as abdominal pain.

Lee et al., from the Houston Methodist Hospital performed a search of all patients who underwent either placement of a new epidural paddle lead electrode or revision of an epidural paddle lead electrode for SCS in the thoracic region from January 2017 to January 2018. They then investigated all cases of immediate postoperative abdominal pain.

They identified 7 patients who had immediate postoperative abdominal pain among 86 cases of epidural SCS procedures. Most patients were discharged on postoperative days 1-3. No patients required revisions or removals of their SCS for any reason.

They conclude that the etiology of immediate postoperative abdominal pain after thoracic paddle lead implantation for SCS is most likely thoracic radiculopathy. They hypothesized that small, transient epidural hematomas could be the cause of this thoracic radiculopathy. They argue that all patients with immediate postoperative abdominal pain and no other neurologic deficits after thoracic paddle lead implantation for SCS should first be treated conservatively with observation and pain management ¹⁾.