Smaller thoracic canal diameters are associated with thoracic radiculopathy and abdominal pain after spinal cord stimulator paddle lead placement

Introduction It is not uncommon for patients to experience postoperative neurologic deficit, thoracic radiculopathy, abdominal pain, or lower extremity paresthesia after the implantation of thoracic spinal cord stimulator (SCS) paddle leads. Smaller thoracic canal diameters have previously been associated with postoperative neurologic deficits. Objective This imaging study examined whether postoperative SCS neurologic complaints other than neurologic deficit may be correlated with thoracic spinal canal diameter. Methods Patients who underwent thoracic laminotomy for SCS paddle lead placement between January 2018 and March 2024 were identified [Correction added on 28 September 2024 after first online publication: The preceding sentence was corrected.]. Preoperative thoracic canal diameter was measured on MRI or CT imaging in the sagittal plane from T5/6 to T11/12. The canal diameters of patients with and without new postoperative neurologic complaints were compared. Results Two hundred forty‐six patients underwent thoracic laminotomy for SCS paddle lead placement. Thoracic radiculopathy, abdominal pain, and lower extremity paresthesia occurred in 3.7% (9/246), 2.8% (7/246), and 2.0% (5/246) patients, respectively. The mean canal diameter for patients without neurologic complaint, thoracic radiculopathy, abdominal pain, and lower extremity paresthesia was 13.1 mm, 12.0 mm (p