Biportal Endoscopic Spinal Cord Stimulation Paddle Lead Implantation: Technical Note and Preliminary Clinical Results

Objective This study aims to elucidate a novel, minimally invasive surgical technique using a biportal endoscope for the implantation of spinal cord stimulation (SCS) paddle leads and to report the preliminary results of its clinical application. Materials and Methods The perioperative data of patients who underwent the biportal endoscopic SCS paddle lead implantation in our department were collected; the surgical procedure was delineated, and the clinical outcomes were assessed. Results From February 2022 to December 2023, six patients underwent biportal endoscopic SCS paddle lead implantation. The median follow-up time was nine months (range one to three months). The median intraoperative blood loss was 30 mL (range 25–50 mL), and the median operative time was 87.5 minutes (range 75–110 minutes). One patient experienced severe neck pain during the operation, whereas the other five patients experienced no surgical complications. One patient was found to have a slight lead migration three months after surgery, which did not affect the therapeutic effect. The median visual analogue scale (VAS) of the surgical area was 0.5 (range 0–2), 2.5 (range 1–4), and 0.5 (range 0–1) during the operation and one day and one week after the operation, respectively. The median VAS of the six patients' primary disease was 8 (range 7–9) before surgery and 2.5 (range 1–4) at the last postoperative follow-up (pain reduction ≥50%). Conclusion Paddle lead systems for SCS can be implanted successfully using a biportal endoscopic technique.