“Rifle loading” back to back paddles

This is a 28 year old male with history of ilioinguinal neuralgia after a hernia repair with nerve involvement.  He had a successful trial at T12-L1 for L1-L2 roots and was felt to be a good candidate for permanent implant.

I typically place paddles via a midline laminotomy, but in this case I wanted to preserve the midline structures in this young patient at the thoracolumbar junction.  I placed two Exclaim paddles end to end like loading shells in a rifle.

 

rifleloading

By anonymous Posted in Lumbar