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Cervical spinal cord stimulator lead migration and transection adjacent to the Foramen Magnum: A case report

Pain Practice Dec 07, 2019

Padalia D, et al. - For the treatment of pain, spinal cord stimulation is identified as a relatively safe therapy, however, it has the potential for several complications including lead migration and breakage. Researchers here illustrated a previously unreported variant of a spinal cord stimulator device failure where transection and cephalad migration of the distal portion of the lead occurred. This occurred in a 53-year-old woman who presented with the complaint of no longer functioning of her cervical spinal cord stimulator (SCS) following a traumatic fall. Fluoroscopy of the neck indicated cephalad migration of one of the MRI conditional leads and transection of the distal aspect. CT indicated a transected portion of the lead in the epidural space, just inferior to the posterior aspect of the foramen magnum, confirming the findings from fluoroscopy. The patient underwent an SCS revision for replacing the lead. However, the distal transected tip was left in place in the epidural space adjacent to the foramen magnum to avoid complications of retrieval. Further, the patient was advised to undergo a repeat x-ray if neck pain or any other concerning symptoms increases. Given the location of the transected portion of the lead, MRI imaging should be avoided.
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