Academic Editor: Sergio Bagnato
Background: Deviation of electrode array from the midline of spinal
cords affects the therapeutic outcomes of C2-4 cervical spinal
cord stimulation (SCS) in patients with disorders of consciousness (DOC).
This study proposed the implementation of a novel C2-3 dural
exposure procedure and investigated its efficacy compared to conventional
surgery. Methods: Surgical and postoperative imaging data from 69
patients with DOC who underwent SCS in the lateral decubitus position were
retrospectively assessed. The C2-3 dural exposure procedure was performed in 16
patients while the rest underwent conventional surgery. The incidence of
electrode deviation was compared, and factors associated with the deviation were
investigated. Results: The rate of complete midline coverage by the
electrodes in the C2-3 dural exposure group was significantly higher than the
conventional group (93.8% vs. 54.7%, p = 0.004). Exposure of the dura
between C2-3 was a significant favorable factor for complete midline coverage by
the electrode array (odds ratio [OR]: 0.091; 95% confidence interval [CI]:
0.011–0.757; p = 0.027). Electrode positioned