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Treating Low Back Pain in Failed Back Surgery Patients with Multicolumn-lead Spinal Cord Stimulation
Published on: June 26, 2018
Spinal Cord Stimulation as a Potential Therapeutic Modality for Managing Concurrent Chronic Low Back and Abdominal
Bi Mo1, Sandra Sacks1,2, Jerry Markar1
1Department of Anesthesiology and Perioperative Medicine, Division of Pain Medicine David Geffen School of Medicine, University of California, Los Angeles Los Angeles California USA.
None:
A 48-year-old man with chronic pancreatitis-related chronic abdominal pain (CAP) and concurrent chronic low back pain (LBP) with radiculopathy had inadequate relief from injectable and opioid therapies. A spinal cord stimulation (SCS) trial with dual leads spanning T4-T6 produced significant CAP relief, leading to permanent implantation at T5, after which he reported improvement in both CAP and LBP. Several months later, analgesia abruptly failed due to caudal lead migration to T7 with high impedance at multiple contacts and unsuccessful reprogramming, prompting referral for surgical revision with paddle leads. This case supports SCS for combined CAP/LBP in selected refractory patients while underscoring device-related complications, such as lead migration, as key limitations requiring close clinical follow-up.
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