possibility of dural tear while explanting scs leads

[painfre]

what is the possibility of dural tear while explanting scs perc medtronic leads? Original medtronic stim was implanted in 2001. Battery revised 3 times in the past from different physicians. The current one is 3 years old and patient wants the leads to removed. Pt has seen neuro surgery outside who referred to pain physician for removal. Is there any possibility of epidural fibrosis or any other difficulty in explanting leads? Is it advisable to attempt this when there is no neurosurgeon to consult in the hosp?

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[clubdeac]

yes there is obvious likelihood of epidural fibrosis and chance or dural tear. Percent? Idk

 

[lobelsteve]

Between zero and slightly more. Likely well under one percent. I think have explanted more than most folks when I returned to a training program and found they stopped using anchors over the leads. No issues to date. Also have taken out a dozen SJM S8 leads with no problems. Nothing to worry about.

 

[painfre]

I do not have experience in explanting the leads before. is the feel same as taking out the leads after trial? if it is a trial lead, i can Just pullout easily with thumb index finger without exerting much force. What if does not come out? Worst the case scenario, cut the leads, close and refer to neurosurgeon is one option I have. Or just refer to different neurosurgeon outside VA for explanting the whole device which is safest off all but spending some more tax payers dollars.

 

[NJPAIN]

Between zero and slightly more. Likely well under one percent. I think have explanted more than most folks when I returned to a training program and found they stopped using anchors over the leads. No issues to date. Also have taken out a dozen SJM S8 leads with no problems. Nothing to worry about.

Just curious Steve, S8 hasn't been around that long. What have been the circumstances under which you have taken a dozen out? Lead migration, fracture,etc or do you not like the S8 and explant it in favor of another array?


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[Aether2000]

I have explanted many without resistance. There is epidural fibrosis that surround the leads and the leads exist within channels inside the epidural fibrosis but there is neither strong adherence of fibrosis.

 

[emd123]

Can happen with paddle explants much more easily, though. Can't it?

 

[lobelsteve]

Just curious Steve, S8 hasn't been around that long. What have been the circumstances under which you have taken a dozen out? Lead migration, fracture,etc or do you not like the S8 and explant it in favor of another array?


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All of the above. Mostly battery issues and loss of pain relief despite stimulus in painful area.

 

[clubdeac]

I stand corrected... disregard my post