{
  "abstract": "Background/importance Both percutaneous and paddle leads are utilized when implanting spinal cord stimulation (SCS). Both leads appear to be safe and effective, yet, there is a scarcity of guidelines for deciding which type of lead a physician should use.Objective The main goal is to provide an overview of clinical indications for percutaneous and paddle leads for SCS in patients with chronic spinal pain.Evidence review Databases consulted for this systematic review were PubMed, Web of Science, Scopus and Embase. Only studies evaluating SCS in chronic spinal pain patients, with or without previous spine surgery, were eligible. The study protocol was prospectively registered (PROSPERO, CRD42022347329).Findings Of the 102 included studies, 66.67% studies (n=68) implanted percutaneous leads, 30.4% (n=31) paddle leads and 2.9% (n=3) paddle leads with a percutaneous approach. Percutaneous leads are implanted when patients have no anatomic abnormalities, including no previous spinal interventions at the target location or thoracolumbar junction, and no previous experience with SCS or intrathecal drug delivery. Percutaneous leads may be considered for patients without a history of spinal surgery. Paddle leads are preferred when percutaneous lead placement is technically too difficult, including patients with a history of previous spine surgeries, or as a rescue therapy for failed percutaneous trials.Conclusions Lead-specific indications were revealed for patients with chronic spinal pain, yet, the experience of the physician or affiliated department is suggested to have an important role. A clinical flowchart is proposed to help physicians in the decision-making process in daily clinical practice.PROSPERO registration number CRD42022347329",
  "authors": [
    {
      "affiliations": [
        "STIMULUS research group, Vrije Universiteit Brussel, Jette, Belgium",
        "Cluster Neurosciences, Center for Neurosciences (C4N), Vrije Universiteit Brussel, Jette, Belgium",
        "Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Jette, Belgium",
        "Department of Neurosurgery, Universitair Ziekenhuis Brussel, Brussels, Belgium",
        "Research Foundation Flanders (FWO), Brussels, Belgium",
        "Department of Radiology, Universitair Ziekenhuis Brussel, Brussels, Belgium"
      ],
      "name": "Maarten Moens"
    },
    {
      "affiliations": [
        "STIMULUS research group, Vrije Universiteit Brussel, Jette, Belgium"
      ],
      "name": "Abdulhamid Ciçek"
    },
    {
      "affiliations": [
        "Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida, USA"
      ],
      "name": "Jiya Anand"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, The University of Arizona College of Medicine Tucson, Tucson, Arizona, USA"
      ],
      "name": "Julie G Pilitsis"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Universitair Ziekenhuis Brussel, Brussels, Belgium"
      ],
      "name": "Michaël Bruneau"
    },
    {
      "affiliations": [
        "PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), CHU de Poitiers, Poitiers, France"
      ],
      "name": "Maxime Billot"
    },
    {
      "affiliations": [
        "PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), CHU de Poitiers, Poitiers, France"
      ],
      "name": "Manuel Roulaud"
    },
    {
      "affiliations": [
        "PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), CHU de Poitiers, Poitiers, France",
        "Service de neurochirurgie du rachis, chirurgie de la douleur et du handicap, CHU de Poitiers, Poitiers, France",
        "Pprime Institute UPR 3346, CNRS, ISAE-ENSMA, Université de Poitiers, Poitiers, France"
      ],
      "name": "Philippe Rigoard"
    },
    {
      "affiliations": [
        "Department of Anesthesiology, Rijnstate Hospital Arnhem, Arnhem, Netherlands"
      ],
      "name": "Jan Willem Kallewaard"
    },
    {
      "affiliations": [
        "STIMULUS research group, Vrije Universiteit Brussel, Jette, Belgium",
        "Cluster Neurosciences, Center for Neurosciences (C4N), Vrije Universiteit Brussel, Jette, Belgium",
        "Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Jette, Belgium",
        "Department of Neurosurgery, Universitair Ziekenhuis Brussel, Brussels, Belgium",
        "Research Foundation Flanders (FWO), Brussels, Belgium"
      ],
      "name": "Lisa Goudman"
    }
  ],
  "title": "Indications for percutaneous and paddle leads for patients with chronic spinal pain: a systematic review",
  "uid": "370ba856-b00f-5bb6-b4b0-f136c8d16463"
}