Spinal Cord Stimulation Therapy for Failed Back Surgery Syndrome in a Patient with Mild Dementia Case Report

Abstract

BACKGROUND: Failed back surgery syndrome (FBSS) continues to become more prevalent as surgical interventions for patients with chronic low back pain increase. Neuromodulation with spinal cord stimulation (SCS) is proven to benefit FBSS. A relative contraindication to SCS therapy is dementia. CASE REPORT: An 81-year-old Hispanic woman with a medical history of dementia and persistent chronic low back pain despite L2-S1 lumbar fusion presented to an outpatient pain clinic with severe low back pain. The patient underwent a SCS trial and followed up with the clinic showing improvement of pain and ability to sit for longer periods of time and sleep longer. After 4 days, the patient underwent implantation of a recharge-free SCS using standard procedure and reported 80% to 90% improvement of pain, decreased dosing of opioid medication, and decrease in blood pressure. CONCLUSION: We successfully implanted a SCS in a patient with dementia and chronic low back pain from FBSS. PRESENTED AS A POSTER: American Society for Pain and Neuroscience Conference 2021; July 23 – 25, 2021 KEY WORDS: Case report, dementia, spinal cord stimulator