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Cervical myelopathy due to an epidural cervical mass after chronic cervical spinal cord stimulation
Andreas Wloch1, H Holger Capelle, Assel Saryyeva
1Department of Neurosurgery, Medical School Hannover, Hannover, Germany.
Background:
Spinal cord stimulation (SCS) is an established treatment for neuropathic pain. Severe long-term complications are rare. Only recently secondary mass lesions associated with chronic stimulation were noted to occur.
Objectives:
To report the rare occurrence of cervical myelopathy secondary to an epidural cervical spinal mass after chronic cervical SCS.
Methods:
Implantation of a paddle electrode at C2-C4 for chronic neuropathic pain resulted in improvement of pain for several years but it lost its efficacy after 8 years. Myelography and postmyelographic CT detected an epidural mass surrounding the electrode and compressing the spinal cord when cervical myelopathy had developed 17 years after electrode implantation.
Results:
The mass which consisted of dense fibrous scar tissue was removed via hemilaminectomy. At postoperative follow-up at 8 months there was no further progression of gait disorder.
Conclusion:
Long-term cervical SCS in a rare case may lead to fibrous epidural mass lesions which may not only cause loss of efficacy but which may also result in new neurological deficits.
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