Percutaneous adjustment method for transversely migrated spinal cord stimulation leads: a technical report

Area of Science:

• Neurosurgery
• Pain Management
• Medical Device Technology

Background:

• Lead migration is a frequent complication of spinal cord stimulation (SCS).
• Revision surgery is the current standard for correcting lead migration but carries risks.
• A minimally invasive alternative is needed to address this common issue.

Observation:

• Four patients with complex regional pain syndrome or failed back surgery syndrome experienced transverse SCS lead migration.
• Radiographic diagnosis confirmed lead migration following recurrence of pain or numbness.
• A novel technique utilizing a bent guide wire through a Tuohy needle was employed for lead repositioning.

Findings:

• The percutaneous epidural technique successfully repositioned migrated SCS leads under C-arm guidance.
• Post-adjustment, patients reported satisfactory pain relief and good electrical stimulation coverage.
• Follow-up periods ranged from 9 to 19 months, demonstrating sustained efficacy.

Implications:

• This technique provides a simple, safe, and cost-effective alternative to revision surgery for transverse SCS lead migration.
• It may improve patient outcomes and reduce healthcare costs associated with SCS complications.
• Further studies could validate this approach in a larger patient cohort.