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Spinal Cord Stimulator Complications: Lead Migration and Malfunction

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Challenging Cases and Complication Management in Pain Medicine

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Abstract

Spinal cord simulation is an effective treatment for chronic intractable pain of many kinds, including neuropathic, ischemic, and visceral. Its use has been demonstrated to aid in not only providing analgesia but also in regaining functionality in terms of return to work. Because it is an invasive technique involving permanent implantation of a medical device, stimulation is typically considered only after more conservative treatments have failed, and it is usually just one component of a multidisciplinary treatment approach. Despite high initial costs, the use of stimulation systems has been shown to be cost-effective in the long term. Adverse events associated with spinal cord stimulation are not common but do occur and can be divided into surgical and hardware complications. Surgical complications include hematoma, seroma, CSF hygroma, infection, wound dehiscence, dural puncture, and spinal cord injury. Many surgical complications can be avoided by preoperative medical planning, and outcomes vary based on intraoperative surgical techniques. Hardware malfunction includes lead migration, lead fraying, and implantable pulse generator failure, each of which requires surgical revision.

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References

  1. Kumar K, Malik S, Demeria D. Treatment of chronic pain with spinal cord stimulation versus alternative therapies: cost-effectiveness analysis. Neurosurgery. 2002;51(1):106–15; discussion 115–6.

    Article  PubMed  Google Scholar 

  2. Health Quality O. Spinal cord stimulation for neuropathic pain: an evidence-based analysis. Ont Health Technol Assess Ser. 2005;5(4):1–78.

    Google Scholar 

  3. Yampolsky C, Hem S, Bendersky D. Dorsal column stimulator applications. Surg Neurol Int. 2012;3(Suppl 4):S275–89.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Peng L, et al. Spinal cord stimulation for cancer-related pain in adults. Cochrane Database Syst Rev. 2015;6:CD009389.

    Google Scholar 

  5. Wu M, Linderoth B, Foreman RD. Putative mechanisms behind effects of spinal cord stimulation on vascular diseases: a review of experimental studies. Auton Neurosci. 2008;138(1–2):9–23.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Kapural L, et al. Spinal cord stimulation for chronic visceral abdominal pain. Pain Med. 2010;11(3):347–55.

    Article  PubMed  Google Scholar 

  7. Tsigaridas N, et al. Spinal cord stimulation in refractory angina. A systematic review of randomized controlled trials. Acta Cardiol. 2015;70(2):233–43.

    Article  PubMed  Google Scholar 

  8. Guan Y, et al. Spinal cord stimulation-induced analgesia: electrical stimulation of dorsal column and dorsal roots attenuates dorsal horn neuronal excitability in neuropathic rats. Anesthesiology. 2010;113(6):1392–405.

    Article  PubMed  Google Scholar 

  9. Guan Y. Spinal cord stimulation: neurophysiological and neurochemical mechanisms of action. Curr Pain Headache Rep. 2012;16(3):217–25.

    Article  PubMed  Google Scholar 

  10. de Andrade DC, et al. Neurophysiological assessment of spinal cord stimulation in failed back surgery syndrome. Pain. 2010;150(3):485–91.

    Article  PubMed  Google Scholar 

  11. Deogaonkar M, et al. Spinal Cord Stimulation (SCS) and Functional Magnetic Resonance Imaging (fMRI): modulation of cortical connectivity with therapeutic SCS. Neuromodulation. 2016;19(2):142–53.

    Article  PubMed  Google Scholar 

  12. Pedrini L, Magnoni F. Spinal cord stimulation for lower limb ischemic pain treatment. Interact Cardiovasc Thorac Surg. 2007;6(4):495–500.

    Article  PubMed  Google Scholar 

  13. Vannemreddy P, Slavin KV. Spinal cord stimulation: current applications for treatment of chronic pain. Anesth Essays Res. 2011;5(1):20–7.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Katayama Y, et al. Motor cortex stimulation for phantom limb pain: comprehensive therapy with spinal cord and thalamic stimulation. Stereotact Funct Neurosurg. 2001;77(1–4):159–62.

    Article  CAS  PubMed  Google Scholar 

  15. Viswanathan A, Phan PC, Burton AW. Use of spinal cord stimulation in the treatment of phantom limb pain: case series and review of the literature. Pain Pract. 2010;10(5):479–84.

    Article  PubMed  Google Scholar 

  16. Medtronics Spinal Cord Stimulation: Patient Selection. http://professional.medtronic.com/pt/neuro/scs/edu/patient-selection/index.htm. kQZEmSrQ1h.

  17. Kreis PG, Fishman S. Spinal cord stimulation: percutaneous implantation techniques. Oxford: Oxford University Press; 2009.

    Google Scholar 

  18. Block AR, Ben-Porath YS, Marek RJ. Psychological risk factors for poor outcome of spine surgery and spinal cord stimulator implant: a review of the literature and their assessment with the MMPI-2-RF. Clin Neuropsychol. 2013;27(1):81–107.

    Article  PubMed  Google Scholar 

  19. Narouze S, et al. Interventional spine and pain procedures in patients on antiplatelet and anticoagulant medications: guidelines from the American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, the American Academy of Pain Medicine, the International Neuromodulation Society, the North American Neuromodulation Society, and the World Institute of Pain. Reg Anesth Pain Med. 2015;40(3):182–212.

    Article  CAS  PubMed  Google Scholar 

  20. Bendersky D, Yampolsky C. Is spinal cord stimulation safe? A review of its complications. World Neurosurg. 2014;82(6):1359–68.

    Article  PubMed  Google Scholar 

  21. Hayek SM, Veizi E, Hanes M. Treatment-limiting complications of percutaneous spinal cord stimulator implants: a review of eight years of experience from an academic center database. Neuromodulation. 2015;18(7):603–9.

    Article  PubMed  Google Scholar 

  22. Zan E, et al. Spinal cord stimulators: typical positioning and postsurgical complications. AJR Am J Roentgenol. 2011;196(2):437–45.

    Article  PubMed  Google Scholar 

  23. Turner JA, et al. Spinal cord stimulation for patients with failed back surgery syndrome or complex regional pain syndrome: a systematic review of effectiveness and complications. Pain. 2004;108(1–2):137–47.

    Article  PubMed  Google Scholar 

  24. Provenzano DA, et al. An international survey to understand infection control practices for spinal cord stimulation. Neuromodulation. 2015.

    Google Scholar 

  25. Meyer SC, Swartz K, Johnson JP. Quadriparesis and spinal cord stimulation: case report. Spine (Phila Pa 1976). 2007;32(19):E565–8.

    Article  Google Scholar 

  26. Jang SS, et al. Case series on variable presentation of ligamentum flavum stimulation following percutaneous cylindrical spinal cord stimulator lead implants. Pain Physician. 2014;17(3):E397–403.

    PubMed  Google Scholar 

  27. Renard VM, North RB. Prevention of percutaneous electrode migration in spinal cord stimulation by a modification of the standard implantation technique. J Neurosurg Spine. 2006;4(4):300–3.

    Article  PubMed  Google Scholar 

  28. Stojanovic MP, Abdi S. Spinal cord stimulation. Pain Physician. 2002;5(2):156–66.

    PubMed  Google Scholar 

  29. Gazelka HM, et al. Incidence of clinically significant percutaneous spinal cord stimulator lead migration. Neuromodulation. 2015;18(2):123–5; discussion 125.

    Article  PubMed  Google Scholar 

  30. Justiz R 3rd, Bentley I. A case series review of spinal cord stimulation migration rates with a novel fixation device. Neuromodulation. 2014;17(1):37–40; discussion 40–1.

    Article  PubMed  Google Scholar 

  31. Connor DE Jr, et al. The utility of bone cement to prevent lead migration with minimally invasive placement of spinal cord stimulator laminectomy leads. Neurosurgery. 2012;71(1):157–63.

    Article  PubMed  Google Scholar 

  32. Kim TH, et al. Spontaneous lead breakage in implanted spinal cord stimulation systems. Korean J Pain. 2010;23(1):78–81.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Knezevic NN, et al. Reprogramming of in situ spinal cord stimulator for covering newly developed postthoracotomy pain. J Clin Anesth. 2015;27(5):411–5.

    Article  PubMed  Google Scholar 

  34. Moeschler SM, et al. Spinal cord stimulator explantation for magnetic resonance imaging: a case series. Neuromodulation. 2015;18(4):285–8; discussion 288.

    Article  PubMed  Google Scholar 

  35. Walsh KM, Machado AG, Krishnaney AA. Spinal cord stimulation: a review of the safety literature and proposal for perioperative evaluation and management. Spine J. 2015;15(8):1864–9.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Anesthesiology, Center for Pain Medicine, University of California San Diego, San Diego, CA, USA

    Mikiko Murakami D.O., Imanuel Lerman M.D. & R. Carter W. Jones III M.D., Ph.D.

Authors
  1. Mikiko Murakami D.O.
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  2. Imanuel Lerman M.D.
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  3. R. Carter W. Jones III M.D., Ph.D.
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Corresponding author

Correspondence to R. Carter W. Jones III M.D., Ph.D. .

Editor information

Editors and Affiliations

  1. Department of Anesthesia and Critical Care, University of Chicago Medicine, Chicago, Illinois, USA

    Magdalena Anitescu

  2. Department of Anesthesiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA

    Honorio T. Benzon

  3. Division of Pain Medicine, Department of Anesthesiology, University of California San Diego School of Medicine, La Jolla, California, USA

    Mark S. Wallace

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Murakami, M., Lerman, I., Jones, R.C.W. (2018). Spinal Cord Stimulator Complications: Lead Migration and Malfunction. In: Anitescu, M., Benzon, H., Wallace, M. (eds) Challenging Cases and Complication Management in Pain Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-60072-7_38

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  • DOI: https://doi.org/10.1007/978-3-319-60072-7_38

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-60070-3

  • Online ISBN: 978-3-319-60072-7

  • eBook Packages: MedicineMedicine (R0)

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