Spinal Cord Stimulator Placement in a Patient with Type 2 von Willebrand’s Disease

Abstract

We present a case of a 76-year-old female with a history of lumbar post-laminectomy pain syndrome and Type II von Willebrand’s disease who underwent successful implantation of a spinal cord stimulator. A consultation with the patient’s hematologist was obtained, and antihemophilic factor/von Willebrand factor complex was administered immediately prior to insertion and removal of trial leads. After reporting greater than 90% pain relief, the patient then underwent permanent implantation with administration of antihemophilic factor/von Willebrand factor complex prior to placement. The epidural space was entered atraumatically, and lead placement was uneventful with minimal resistance met. Leads were tunneled to her right gluteal region, where a pocket was created for her generator. She continues to report good relief without neurological signs of epidural hematoma nearly 6 months post-procedure. Key words: von Willebrand disease, high-frequency spinal cord stimulator, post-laminectomy pain syndrome