Surgical Technique: Placement of Thoracic Spinal Cord Stimulator Paddle Leads

This study highlights the surgical options for accurate midline placement of thoracic SCS paddle leads: below-level laminotomy for most cases, same-level laminotomy for patients with thoracic stenosis, and two-level laminotomy for challenging placements. We advocate for preoperative imaging and individualized surgical methods based on preoperative canal diameter measurements and intraoperative findings to ensure safe placement.