Spinal Cord Compression Secondary to Epidural Fibrosis Associated with Percutaneously Placed Spinal Cord Stimulation Electrodes: Case Report and Review of the Literature.

Spinal Cord Compression Secondary to Epidural Fibrosis Associated with Percutaneously Placed Spinal Cord Stimulation Electrodes: Case Report and Review of the Literature.

World Neurosurg. 2017 Jun 02;:

Authors: Al Tamimi M, Aoun SG, Gluf W

Abstract
Spinal cord stimulation is a safe method for treating chronic pain syndromes. Spinal cord stimulators can be placed, either surgically by creating a laminectomy defect for paddle leads, or percutaneously by inserting electrodes. They are usually not associated with major complications. There have been several reports of epidural fibrosis formation after paddle lead placement but only one case of excessive fibrosis following percutaneous lead placement. We describe the unique case of excessive cervical fibrosis formation with creation of tolerance phenomenon, clinically significant stenosis, cord compression, and myelopathy after percutaneous lead placement, that improved after surgical removal of the implant. We also reviewed the PubMed and Medline databases for all cases of significant epidural fibrosis related to spinal cord stimulator lead placement, including both surgically implanted paddles and percutaneously implanted leads. This is an uncommon complication after placement of spinal cord stimulators, but it can carry a clinically significant impact, and be the source of severe morbidity. It should especially be suspected if the successful placement of the device is followed by the development of a "tolerance" phenomenon, with progressive loss of satisfactory pain control, and development of new myelopathic symptoms.

PMID: 28583460 [PubMed - as supplied by publisher]

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