Experience with 509 plate electrodes implanted epidurally from C1 to L1

This article summarizes the experience gained with implantation of 509 plate electrodes performed by a single neurosurgeon. 350 patients were subjected to implantation of plate electrodes in the dorsal epidural space. 227 patients were implanted for chronic pain management (reflex sympathetic dystrophy, failed back syndrome/arachnoiditis, pain following spinal cord injury, nerve injury pain and other miscellaneous pain conditions), 105 patients for motor disorders (spasms/spasticity following spinal cord or head injury, cerebral palsy, multiple sclerosis, spasmodic torticollis and other miscellaneous conditions) and 18 patients for both. A total of 509 electrodes were implanted in the dorsal epidural space. The electrodes types were: 442 Medtronic Resume, 39 Medtronic Resume-TL and 25 Neuromed Lamitrode. 378 electrodes were implanted for chronic pain management, 106 for motor disorders and 25 in patients presenting with both pain and motor disorders. 192 electrodes were implanted in the cervical area and 317 in the thoracic area. 3.7% of the implanted electrodes became infected and had to be surgically removed. Electrode migration occurred in 1.1% of the patients and electrode breakage in 4 patients. 288 (70%) of the implanted electrodes are still being used. Technical factors relevant to the surgical implantation of plate electrodes at various levels in the spine are presented and discussed.