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Updated: Sep 26, 2025

Treating Low Back Pain in Failed Back Surgery Patients with Multicolumn-lead Spinal Cord Stimulation
Published on: June 26, 2018
Perioperative Management of Spinal Cord Stimulators and Intrathecal Pain Pumps
Alan H Daniels1, Christopher L McDonald, Bryce A Basques
1From the Department of Orthopedic Surgery, Warren Alpert Medical School/Brown University, Providence, RI (Daniels, McDonald, and Basques), and the Harvard Medical School, Massachusetts General Hospital, Boston, MA (Hershman).
Abstract:
Spinal cord stimulators (SCSs) and intrathecal pain pumps (IPPs) are implantable devices used in the management of chronic pain or spasticity. Complications, such as infection, lead migration/failure, cerebrospinal fluid leak, neurologic injury, and other medical complications, can occur after placement and may require surgical intervention. Orthopaedic surgeons may encounter patients with these devices and should have a basic understanding of their function. In addition, they should be aware that patients may have residual stenosis or deformity contributing to their symptoms; thus, spine surgery referral may be indicated. If a patient with a SCS or IPP is undergoing revision spinal surgery, a preoperative discussion regarding retention versus removal of the device is imperative because indications for device retention, revision, and removal are complex. This review summarizes potential complications and intraoperative considerations concerning the proper perioperative management of SCSs/IPPs and will provide evidence-based data regarding management strategies for these devices.
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