Percutaneous electrode placement for spinal cord stimulation in a patient with spinal fusion: a technical report |
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Authors: | Sung-Chun Park Kyung-Hoon Kim |
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Institution: | (1) Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Pusan, Korea;(2) Pain Clinic, Pusan National University Yangsan Hospital, Bumeuri, Mulgeumup, Yangsan, Kyungsangnamdo, 626-770, Korea; |
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Abstract: | A spinal cord stimulation (SCS) trial was attempted to alleviate left knee pain in a patient with spinal fusion from T12 to
L4. Good paresthesia coverage for the knee pain was attained with SCS. However, while removing the needle used for electrode
placement, the needle became fixed in the bony supplementary tissue. Moreover, while attempting to remove the needle using
Kelly forceps, the hub of the needle became blocked. Without the hub, we had no choice but to use a pneumatic drill for removing
the needle. Accordingly, the supplementary bone tissue was drilled under real-time imaging, using a pneumatic drill with a
3.2-mm drill bit, and another epidural needle was inserted through the hole. We consider that, in patients with spinal fusion,
making a borehole with a pneumatic drill for introducing the epidural needle for percutaneous SCS electrode placement may
be advisable in order to avoid the above-mentioned difficulties. |
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