Spinal cord stimulation (SCS) has become a successful therapeutic option in combating chronic pain and can be implanted via percutaneous or open (laminotomy/laminectomy) techniques. This study aims to systematically review the complications that occur after SCS placement via percutaneous and open (laminotomy/laminectomy) in Failed Back Surgery Syndrome (FBSS), Complex Regional Pain Syndrome (CRPS) and chronic back (lumbosacral)/leg pain. PubMed and METHODS: EMBASE databases were searched from inception to June 2020; Prospective studies using SCS in FBSS, CRPS, and chronic low back pain patients that reported both complications and implantation method used were included. Effects and results from each study were combined using a random-effects model and were structured for subgroup analysis between open and percutaneous implantation. Meta-regression was performed by calculating a mean difference and weighted by inverse variance and 95% confidence intervals.
Thirty-two articles were included in the systematic review and meta-analysis. Using several different patient and event-based metrics, meta-analysis revealed an overall average complications rate of 21.1% [95% confidence interval, 14.9.-27.2]. Equipment, technical, and medical complications occurred at a rate of 12.1%, 1.1%, and 6.3%, respectively. Lead migration and infection rates were 5.6% and 3.8%, respectively. When comparing the two implant techniques, medical-related surgical reinterventions, and explants due to infection were more common in open rather than in percutaneous SCS procedures.
Equipment-related complications accounted for the majority of SCS complications. Further, percutaneous SCS resulted in less reinterventions and explants caused by medical-related complications and infection, respectively. These conclusions may provide a general understanding of the SCS complications profile to physicians who care for SCS patients.

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