Posters
Presentation Type
Poster
Discipline Track
Clinical Science
Abstract Type
Case Report
Abstract
Summary of background data: Spinal cord injury is a rare but devastating complication of spinal cord stimulator implantation; the incidence has been reported variably, ranging from 0.45 to 2.13% 1.
Objectives: To report a case of spinal cord injury developed postoperatively after revisional spinal cord stimulator placement in a patient with cervical central canal stenosis.
Methods: A case study
Results: Spinal Cord Injury ASIA scale C
Case Description: A 51-year-old female with 5-year chronic neck pain with radiating pain on both upper extremities came with lower extremity weakness and ataxia after revisional cervical spinal cord stimulator placement. In April 2021, she underwent primary placement of a percutaneous spinal cord stimulator which lost its effect after 3 months due to lead migration. Ten months later, ACDF on C5/6 had been done by a different provider, it did not help her pain either. After 4 months, she underwent the removal and replacement of the cervical spinal cord stimulator, and lower extremity weakness and ataxia developed immediately after the procedure. No immediate management was done. She had undergone ACDF on C4/5 for further decompression, but no improvement was seen. Despite the removal of a spinal cord stimulator on POD 8 months regarding further compression of the cord or cord irritation, she has minimal improvement in her lower extremities one month after.
Discussion/Conclusion: Spinal cord injury can result from direct trauma by needle puncture and lead placement during percutaneous spinal cord implantation. The revision procedure needs a cautious approach because fibrotic tissue from previous surgery complicates the approach to epidural space2. Cervical stenosis is noted as a significant risk factor due to compromised cross-sectional area in the spinal canal which increases cord compression and contusion during the advancement of leads3. Thus, consideration should be given to revisional cervical cord stimulator implantation in cervical central canal stenosis.
Academic/Professional Position
Resident
Recommended Citation
Yi, Changho and Faye, Justin, "Spinal Cord Injury After Revisional Placement of Percutaneous Cervical Spinal Cord Stimulator in the Patient with Cervical Central Canal Stenosis: A Case Study" (2024). Research Symposium. 10.
https://scholarworks.utrgv.edu/somrs/2023/posters/10
Included in
Spinal Cord Injury After Revisional Placement of Percutaneous Cervical Spinal Cord Stimulator in the Patient with Cervical Central Canal Stenosis: A Case Study
Summary of background data: Spinal cord injury is a rare but devastating complication of spinal cord stimulator implantation; the incidence has been reported variably, ranging from 0.45 to 2.13% 1.
Objectives: To report a case of spinal cord injury developed postoperatively after revisional spinal cord stimulator placement in a patient with cervical central canal stenosis.
Methods: A case study
Results: Spinal Cord Injury ASIA scale C
Case Description: A 51-year-old female with 5-year chronic neck pain with radiating pain on both upper extremities came with lower extremity weakness and ataxia after revisional cervical spinal cord stimulator placement. In April 2021, she underwent primary placement of a percutaneous spinal cord stimulator which lost its effect after 3 months due to lead migration. Ten months later, ACDF on C5/6 had been done by a different provider, it did not help her pain either. After 4 months, she underwent the removal and replacement of the cervical spinal cord stimulator, and lower extremity weakness and ataxia developed immediately after the procedure. No immediate management was done. She had undergone ACDF on C4/5 for further decompression, but no improvement was seen. Despite the removal of a spinal cord stimulator on POD 8 months regarding further compression of the cord or cord irritation, she has minimal improvement in her lower extremities one month after.
Discussion/Conclusion: Spinal cord injury can result from direct trauma by needle puncture and lead placement during percutaneous spinal cord implantation. The revision procedure needs a cautious approach because fibrotic tissue from previous surgery complicates the approach to epidural space2. Cervical stenosis is noted as a significant risk factor due to compromised cross-sectional area in the spinal canal which increases cord compression and contusion during the advancement of leads3. Thus, consideration should be given to revisional cervical cord stimulator implantation in cervical central canal stenosis.