Placement of an electrode array as a dural substitute for dorsal column stimulation: technical note

Area of Science:

• Neurosurgery
• Pain Management
• Biomaterials

Background:

• Dorsal column stimulation (DCS) is a neuromodulation technique for chronic pain.
• Connective tissue proliferation around the DCS electrode array can impede electrical current and lead to treatment failure.
• Dural thickening is a known complication that can compromise DCS efficacy.

Observation:

• A case report details a patient experiencing treatment failure with DCS due to significant dural thickening at the C2-C3 level.
• The thickened dura prevented adequate electrical penetration from the implanted electrode array.
• This complication led to insufficient neuromodulation and persistent pain symptoms.

Findings:

• Surgical excision of the thickened dura was performed.
• The DCS electrode array was repurposed and utilized as a dural substitute following excision.
• This novel approach facilitated sufficient electrical current penetration and effective DCS.

Implications:

• Repurposing implanted hardware as a dural substitute offers a potential solution for DCS-induced dural thickening.
• This case highlights a viable strategy to salvage DCS therapy in patients experiencing treatment failure due to dural complications.
• Further research may explore the long-term efficacy and safety of using electrode arrays as dural substitutes in neuromodulation procedures.