Introduction: Spinal cord stimulation (SCS) is a surgical technique for chronic pain. Because paddle lead SCS is an invasive procedure, it may be less commonly offered to older patients. We evaluated safety and efficacy of paddle lead SCS placement in this population.
Methods: We conducted a retrospective chart review of a single-surgeon prospective database of all paddle lead spinal cord stimulators implanted at our institution from January 2019 through July 2024. Octogenarian patients were identified and their data analyzed, including demographics and treatment history. Post-operative pain was measured using subjective data collected from patient interviews. Descriptive statistics were completed, a one-way ANOVA test was used to measure the mean postoperative pain levels.
Results: The study cohort included 60 patients with a median age of 83 (IQR 81-85). 56% of patients had concurrent back and leg pain. Patients who achieved a large improvement in pain symptoms were more likely to present with concurrent back and leg pain (p < 0.05). Only two patients (3.3%) had postoperative infections; three patients (4.9%) had the device removed. Frequency of pain improvement amongst patients with isolated leg pain was 76 (±17), isolated back pain 71 (±17) and concurrent back and leg pain 72 (±16).
Conclusion : Paddle lead SCS may be performed safely in octogenarians with no obvious increase in complications or reduced efficacy. Paddle lead SCS implantation should be considered in octogenarian patients with chronic pain.
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