Introduction: Spinal cord stimulation (SCS) provides a relatively safe treatment for intractable pain, however it has some risks. The complication rate of SCS is wide range from 8% to 75% in the literatures. We reviewed 5 complicated cases of spinal cord stimulation.
Methods: A cumulative total number of people from 2012 was 14 cases included 9 SCS trials and 5 implantations of implantable pulse generators (IPG) in this retrospective study. There were 13 men and 1 woman aged from 39 to 89 years (mean 56.2 years).SCS trial was performed for failed back surgery syndrome (FBSS) in 5 patients, syringomyelia in 2 patients, cerebral hemorrhage in 2 patients, in which implantation of IPG was performed for FBSS in 3 patients, syrigomyelia in 1 patient, and cerebral hemorrhage in 1 patient.
Results: There were 5 complicated cases (35.7%), in which, a heat sensation over the IPG, a severe pain in left arm with syringomyelia due to granulation around the surgical lead, a transient motor weakness of both lower limbs after paddle lead implantation and two cases of percutaneous lead dislocation without symptoms were included. We perfomed operation for the first two cases and conservative management for the last three cases. Their three symptoms improved.
Conclusions: Spinal cord stimulation is a useful treatment for intractable pain, however it has more or less complication.Percutaneous leads were used easily but dislocated relatively. Surgical leads (paddle type) were useful for the complex pain, however they might have more invasive complication such as syrigomyelia. The safe strategy should be needed to reduce the comlications, especially when using the surgical leads.
Patient Care: Our research will understand the risks of spinal cord stimulation, and perform SCS more safety.
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the importance of complications of spinal cord stimulation 2) Discuss, in small groups, about safe use of SCS and reduce of complication , 3) Identify an effective treatment for intracable pain due to FBSS and CRPS and other "