A Unique Approach to Neurostimulation in Patients With Previous Two‐Segment Spine Surgery and Obstruction of Epidural Access for Spinal Cord Stimulation: A Case Series |
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| Authors: | Y Eugene Mironer MD Philip J Hodge MD J Talley Parrott MD Sumeer Lal MD Phillip C LaTourette MD |
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| Institution: | 1. Carolinas Center for Advanced Management of Pain, NC‐SC, Spartanburg, SC, USA;2. Southeastern Neurosurgical & Spine Institute, Greenville, SC, USA;3. Orthopedic & Spine Surgeons of SC, Columbia, SC, USA;4. Carolina Neurosurgery, Greenwood, SC, USA |
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| Abstract: | Introduction: Patients with extensive surgery in the lumbar and thoracic spine are often not considered for neurostimulation due to the inability to perform a conventional spinal cord stimulation (SCS) trial. We are presenting six such patients in which spinal‐peripheral neurostimulation (SPN) was used via a caudal approach. Methods: Six patients with intractable low back and leg pain following extensive lumbar and thoracic surgeries, up to at least the T10 level, underwent a stimulation trial with one caudal lead and one subcutaneous lead in order to achieve SPN. Results: In five cases, the trial was successful with coverage of the pain area and at least satisfactory pain relief. All six patients were implanted with a paddle lead(s) and a subcutaneous lead using SPN with good pain control. Conclusion: SPN with a caudal lead appears to be a viable option for SCS trial in patients with no possibilities for conventional trial lead placement. |
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| Keywords: | Failed back surgery syndrome low back pain peripheral nerve stimulation SCS spinal cord stimulation |
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