Spinal cord stimulator complications: Lead migration and malfunction

Abstract

Spinal cord simulation is an effective treatment for chronic intractable pain of many kinds, including neuropathic, ischemic, and visceral. Its use has been demonstrated to aid in not only providing analgesia but also in regaining functionality in terms of return to work. Because it is an invasive technique involving permanent implantation of a medical device, stimulation is typically considered only after more conservative treatments have failed, and it is usually just one component of a multidisciplinary treatment approach. Despite high initial costs, the use of stimulation systems has been shown to be cost-effective in the long term. Adverse events associated with spinal cord stimulation are not common but do occur and can be divided into surgical and hardware complications. Surgical complications include hematoma, seroma, CSF hygroma, infection, wound dehiscence, dural puncture, and spinal cord injury. Many surgical complications can be avoided by preoperative medical planning, and outcomes vary based on intraoperative surgical techniques. Hardware malfunction includes lead migration, lead fraying, and implantable pulse generator failure, each of which requires surgical revision.