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Persistent pain following lumbar disc replacement.
Kevin L Wininger1, Kedar K Deshpande, Michelle L Bester
1Orthopaedic & Spine Center in Columbus, Ohio, USA.
Radiologic Technology
|May 19, 2012
Summary
Spinal cord stimulation (SCS) effectively manages intractable pain after artificial disc replacement when other treatments fail. This neuroaugmentive technique significantly improved a patient's quality of life and reduced pain by over 75%.
Area of Science:
- Spinal surgery
- Pain management
- Biomechanical modeling
Background:
- Facet and sacroiliac joint pain after lumbar total disc replacement (TDR) correlates with biomechanical load transfer.
- Intractable pain following TDR often necessitates advanced treatment options when conventional therapies are exhausted.
Observation:
- A patient with persistent pain post-TDR, unresponsive to injections and physical therapy over three years, was considered for spinal cord stimulation (SCS) over reoperation.
- A constant-current multiple source SCS system was implanted.
Findings:
- At 12-month follow-up, the implanted SCS system reduced the patient's pain by over 75%.
- The patient reported significant improvements in quality of life, including restored restful sleep.
Implications:
- Spinal cord stimulation (SCS) presents a viable and effective neuroaugmentive technique for managing refractory pain associated with artificial disc implants.
- This case highlights the potential of SCS as an alternative to fusion surgery for intractable pain after TDR.
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