Techniques to mitigate lead migration for percutaneous trials of cervical spinal cord stimulation

Lead migration was primarily confined to the rostrocaudal axis with the most migration occurring during the first week. Iterative improvements to the implantation procedure were implemented to increase lead stability across subjects. There was a decrease in lead migration for patients who had more rostral placement of the SCS leads. The average migration from the day of lead implant to lead removal was 29.7 mm for Subject 1 (lead placement ranging from T3-T4 to T1-T2), 41.9 mm for Subject 2 (T2-T3 to C7-T1), 1.9 mm for Subject 3 (T1-T2 to C7-T1), and 16.6 mm for Subject 4 (T1-T2 to C7-T1). We found that initial placement of spinal cord stimulator leads in the cervical epidural space as rostral as possible was critical to minimizing subsequent rostrocaudal lead migration.