Impact to spinal cord stimulator lead integrity with direct suture loop ties

Abstract

Background. Lead migration of spinal cord stimulators (SCS) is a significant problem, and experience suggests that anchoring sutures directly around the SCS lead may reduce migration. Such practices have been limited by concerns about potential damage to the lead and impairment of performance. Objective. This study sought to determine the extent of overt damage following maximal tension from tying sutures directly around SCS leads. Design. Twenty-eight SCS leads were prospectively exposed to 56 suture knots that were tightened under controlled conditions to the suture's breaking point. [Outcome Measures. Lead damage was evaluated by high power microscopy and assessment of lead impedance. Results. None of the leads had evidence of substantial physical damage or electrical impairment. Conclusions. This small study suggests that anchoring directly to the lead appears to produce minimal damage, but these preliminary data must be confirmed and expanded. © 2009 American Academy of Pain Medicine.