{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:14:09Z","timestamp":1787771649210,"version":"build-2784847793"},"reference-count":29,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T00:00:00Z","timestamp":1759449600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Boston Scientific"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Spinal cord stimulation (SCS) is a well-established treatment for chronic neuropathic pain, offering a safe procedure with low complication rates. Both surgical and percutaneous leads can be effective, with similar complication rates. Methods: We analyzed all patients implanted at a reference center since 1996 to compare pain control and complications and determine whether one system was more effective than the other in patients who had experienced both systems. A retrospective observational study was designed. Results: A total of 188 SCS systems were implanted, with a follow-up period of 79.71 \u00b1 60.39 months (mean \u00b1 SD). We analyzed data from 106 males (56.38%) and 82 females (43.62%), ranging from 15 to 76 years old. A total of 68 (36.17%) surgical leads and 120 (63.83%) percutaneous leads were implanted for failed back syndrome (120, 63.83%), complex regional pain syndrome (56, 29.79%), and other conditions (12, 6.38%). No statistically significant differences were found in any variables except for lead migration (p = 0.05). In patients who initially had a percutaneous system and later received a surgical system, we found a statistically significant difference in pain relief percentage (p = 0.03) and a trend toward statistical significance in the PGI-C score (p = 0.08). Conclusions: Both surgical and percutaneous leads have demonstrated similar pain control rates, but percutaneous leads have a higher migration rate. Complications can be minimized by performing the procedure in specialized centers with extensive experience. Further studies comparing both systems should be conducted to determine if one type of lead is superior.<\/jats:p>","DOI":"10.3390\/jcm14197013","type":"journal-article","created":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T11:53:37Z","timestamp":1759492417000},"page":"7013","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Comparison Between Surgical and Percutaneous Paddles in Spinal Cord Stimulation for Chronic Neuropathic Pain"],"prefix":"10.3390","volume":"14","author":[{"given":"Marta Antonia","family":"G\u00f3mez-Gonz\u00e1lez","sequence":"first","affiliation":[{"name":"Functional Neurosurgery Unit, Department of Neurosurgery, Hospital Universitario Virgen de las Nieves, Juan Pablo II Avenue, S\/N, 4th Floor, 18013 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7265-3519","authenticated-orcid":false,"given":"Nicol\u00e1s","family":"Cordero-Tous","sequence":"additional","affiliation":[{"name":"Functional Neurosurgery Unit, Department of Neurosurgery, Hospital Universitario Virgen de las Nieves, Juan Pablo II Avenue, S\/N, 4th Floor, 18013 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"S\u00e1nchez-Corral","sequence":"additional","affiliation":[{"name":"Functional Neurosurgery Unit, Department of Neurosurgery, Hospital Universitario Virgen de las Nieves, Juan Pablo II Avenue, S\/N, 4th Floor, 18013 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Lechuga-Carrasco","sequence":"additional","affiliation":[{"name":"Functional Neurosurgery Unit, Department of Neurosurgery, Hospital Universitario Virgen de las Nieves, Juan Pablo II Avenue, S\/N, 4th Floor, 18013 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9614-4867","authenticated-orcid":false,"given":"Manuel Alejandro","family":"S\u00e1nchez-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Pain Unit, Department of Anesthesiology, Reanimation and Pain Management, Hospital Universitario Virgen de las Nieves, Juan Pablo II Avenue, S\/N, 2nd Floor, 18013 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"G\u00e1lvez-Mateos","sequence":"additional","affiliation":[{"name":"Pain Unit, Department of Anesthesiology, Reanimation and Pain Management, Hospital Universitario Virgen de las Nieves, Juan Pablo II Avenue, S\/N, 2nd Floor, 18013 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gonzalo","family":"Olivares-Granados","sequence":"additional","affiliation":[{"name":"Functional Neurosurgery Unit, Department of Neurosurgery, Hospital Universitario Virgen de las Nieves, Juan Pablo II Avenue, S\/N, 4th Floor, 18013 Granada, Spain"},{"name":"Department of Anatomy, University of Granada, Doctor Jesus Candel Fabregas Avenue 11, 18016 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,3]]},"reference":[{"key":"ref_1","unstructured":"International Association for the Study of Pain (IASP) (2025, May 15). IASP Announces Revised Definition of Pain. 16 July 2020. Available online: https:\/\/www.iasp-pain.org\/publications\/iasp-news\/iasp-announces-revised-definition-of-pain\/."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1152\/physrev.00045.2019","article-title":"Neuropathic Pain: From Mechanisms to Treatment","volume":"101","author":"Finnerup","year":"2021","journal-title":"Physiol. Rev."},{"key":"ref_3","unstructured":"International Association for the Study of Pain (IASP) (2025, May 15). Neuropathic Pain. 7 July 2021. Available online: https:\/\/www.iasp-pain.org\/advocacy\/global-year\/neuropathic-pain\/."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/j.jpain.2005.11.008","article-title":"The Epidemiology of Chronic Pain of Predominantly Neuropathic Origin. Results From a General Population Survey","volume":"7","author":"Torrance","year":"2006","journal-title":"J. Pain"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"104232","DOI":"10.1016\/j.lpm.2024.104232","article-title":"Neuropathic pain: Evidence based recommendations","volume":"53","author":"Moisset","year":"2024","journal-title":"Presse Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.neurol.2018.09.016","article-title":"Neuropathic pain: Definition, assessment and epidemiology","volume":"175","author":"Bouhassira","year":"2019","journal-title":"Rev. Neurol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1016\/j.neurom.2022.08.456","article-title":"Comparison of Characteristics, Inpatient Outcomes, and Trends in Percutaneous Versus Open Placement of Spinal Cord Stimulators","volume":"26","author":"Spirollari","year":"2023","journal-title":"Neuromodul. Technol. Neural Interface"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.nec.2018.12.003","article-title":"Spinal Cord Stimulation","volume":"30","author":"Rock","year":"2019","journal-title":"Neurosurg. Clin. N. Am."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1359","DOI":"10.1016\/j.wneu.2013.06.012","article-title":"Is spinal cord stimulation safe? A review of its complications","volume":"82","author":"Bendersky","year":"2014","journal-title":"World Neurosurg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1111\/ner.12370","article-title":"The Incidence of Spinal Cord Injury in Implantation of Percutaneous and Paddle Electrodes for Spinal Cord Stimulation","volume":"19","author":"Petraglia","year":"2016","journal-title":"Neuromodul. Technol. Neural Interface"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"254","DOI":"10.3171\/spi.2004.100.3.0254","article-title":"Safety and efficacy of spinal cord stimulation for the treatment of chronic pain: A 20-year literature review","volume":"100","author":"Cameron","year":"2004","journal-title":"J. Neurosurg. Spine"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.pain.2007.07.028","article-title":"Spinal cord stimulation versus conventional medical management for neuropathic pain: A multicentre randomised controlled trial in patients with failed back surgery syndrome","volume":"132","author":"Kumar","year":"2007","journal-title":"PAIN"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1055\/s-0034-1371517","article-title":"Paddle versus cylindrical leads for percutaneous implantation in spinal cord stimulation for failed back surgery syndrome: A single-center trial","volume":"75","author":"Kinfe","year":"2014","journal-title":"J. Neurol. Surg. Part A Central Eur. Neurosurg."},{"key":"ref_14","unstructured":"(2025, May 15). The History of Spinal Cord Stimulation For Chronic Pain\u2013The Old and the New-Genesis Research Services. Available online: https:\/\/genesisresearchservices.com\/the-history-of-spinal-cord-stimulation-for-chronic-pain-the-old-and-the-new\/."},{"key":"ref_15","first-page":"293","article-title":"Spinal Cord Stimulation Trends of Utilization and Expenditures in Fee-For-Service (FFS) Medicare Population from 2009 to 2018","volume":"24","author":"Manchikanti","year":"2021","journal-title":"Pain Physician"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.1016\/j.neurom.2022.11.010","article-title":"Spinal Cord Stimulator (SCS) Placement: Examining Outcomes Between the Open and Percutaneous Approach","volume":"26","author":"Beletsky","year":"2023","journal-title":"Neuromodul. Technol. Neural Interface"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.wneu.2021.07.077","article-title":"Spinal Cord Stimulation via Percutaneous and Open Implantation: Systematic Review and Meta-Analysis Examining Complication Rates","volume":"154","author":"Blackburn","year":"2021","journal-title":"World Neurosurg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"S125","DOI":"10.1016\/j.neuchi.2014.06.004","article-title":"\u201cMAST\u201d prospective study: Value of minimal access spine technologies technique for multicolumn spinal cord stimulation surgical lead implantation in the context of a French multicentre randomized controlled trial (ESTIMET study)","volume":"61","author":"Monlezun","year":"2015","journal-title":"Neurochirurgie"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1097\/00006123-200002000-00025","article-title":"Laminectomy versus percutaneous electrode placement for spinal cord stimulation","volume":"46","author":"Villavicencio","year":"2000","journal-title":"Neurosurgery"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1159\/000505707","article-title":"Spinal Cord Stimulation with Surgical Lead Improves Pain and Gait in Parkinson\u2019s Disease after a Dislocation of Percutaneous Lead: A Case Report","volume":"98","author":"Lai","year":"2020","journal-title":"Ster. Funct. Neurosurg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1111\/papr.12871","article-title":"Percutaneously Inserted Unilateral Lead Migration Salvaged with a Paddle Electrode","volume":"20","author":"Oh","year":"2020","journal-title":"Pain Pract."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1111\/j.1525-1403.2009.00262.x","article-title":"Spinal cord stimulation with percutaneous leads after loss of coverage with implanted surgical lead","volume":"13","author":"Yakovlev","year":"2010","journal-title":"Neuromodul. Technol. Neural Interface"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1097\/01.ajp.0000146217.31780.ef","article-title":"Age and the experience of chronic pain: Differences in health and quality of life among younger, middle-aged, and older adults","volume":"21","author":"Wahl","year":"2005","journal-title":"Clin. J. Pain"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e60160","DOI":"10.2196\/60160","article-title":"Following Up Patients With Chronic Pain Using a Mobile App With a Support Center: Unicenter Prospective Study","volume":"12","year":"2025","journal-title":"JMIR Hum. Factors"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.jpain.2007.09.005","article-title":"Interpreting the clinical importance of treatment outcomes in chronic pain clinical trials: IMMPACT recommendations","volume":"9","author":"Dworkin","year":"2008","journal-title":"J. Pain"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1002\/ejp.1776","article-title":"High-frequency spinal cord stimulation as rescue therapy for chronic pain patients with failure of conventional spinal cord stimulation","volume":"25","year":"2021","journal-title":"Eur. J. Pain"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"E285","DOI":"10.36076\/ppj.2024.27.E285","article-title":"Factors Associated With Same Day Discharge Post-Spinal Cord Stimulator Placement","volume":"27","author":"Beletsky","year":"2024","journal-title":"Pain Physician"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1111\/ner.12184","article-title":"Incidence of clinically significant percutaneous spinal cord stimulator lead migration","volume":"18","author":"Gazelka","year":"2015","journal-title":"Neuromodul. Technol. Neural Interface"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/j.neurom.2024.10.007","article-title":"Cylindrical vs Paddle Leads in Spinal Cord Stimulation for the Long-term Treatment of Chronic Pain: A Systematic Review and Meta-analysis","volume":"28","author":"Wronowski","year":"2025","journal-title":"Neuromodul. Technol. Neural Interface"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/19\/7013\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,5]],"date-time":"2025-10-05T04:17:39Z","timestamp":1759637859000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/19\/7013"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,3]]},"references-count":29,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["jcm14197013"],"URL":"https:\/\/doi.org\/10.3390\/jcm14197013","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,3]]}}}