Case report: Dorsal root ganglion stimulator lead fracture.

IF 2.5 3区医学 Q2 ANESTHESIOLOGY

Pain Practice Pub Date : 2024-04-01 Epub Date: 2023-12-15 DOI:10.1111/papr.13335

Suhas Kochat, Jacob Byers, Peter K Yi

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引用次数: 0

Abstract

Background: One of the unique advances in neuromodulation for chronic pain has been spinal cord stimulators (SCS) and dorsal root ganglion stimulators (DRG-S). These devices have aided in conditions such as neuropathic pain, complex regional pain syndromes, failed back surgery, and peripheral neuropathies. With these benefits, however, complications from implantable stimulators have included lead fractures and migration. The authors reviewed a lead migration, kinking, and subsequent fracture event involving a patient with complex regional pain syndrome (CRPS) II, who was treated with a DRG-S.

Case presentation: The case report follows this patient, from their past medical history to assessment of appropriate qualifications for neuromodulation, to successful surgical placement, to follow-up care. The authors further monitored assessment of inefficacy of pain relief, and identification of lead migration and kinking through imaging. In the process of removal, due to lead stress, lead fracturing occurred. After lead removal, the leads were fully replaced, and the patient was followed up and experienced improved pain relief.

Conclusion: The case report assesses probable mechanisms of lead fracture and considerations for physicians for future assessment and triage of neuromodulation efficacy.

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病例报告：背根神经节刺激器导线断裂。

背景：脊髓刺激器（SCS）和背根神经节刺激器（DRG-S）是神经调节治疗慢性疼痛的独特进展之一。这些设备有助于治疗神经病理性疼痛、复杂区域疼痛综合征、背部手术失败和周围神经病等疾病。然而，在带来这些益处的同时，植入式刺激器的并发症也包括导线断裂和移位。作者回顾了一名接受 DRG-S 治疗的复杂性区域疼痛综合征 (CRPS) II 患者的导线移位、扭结和随后的骨折事件：本病例报告跟踪了该患者从既往病史到神经调控适当资格评估，再到成功手术置入，以及后续护理的整个过程。作者进一步监测了疼痛缓解效果不佳的评估，并通过影像学检查发现了导线移位和扭结。在移除过程中，由于导联应力，发生了导联断裂。取出导联后，对导联进行了完全置换，并对患者进行了随访，其疼痛缓解情况有所改善：本病例报告评估了导联断裂的可能机制，并为医生今后评估和分流神经调控疗效提供了参考。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pain Practice ANESTHESIOLOGY-CLINICAL NEUROLOGY

CiteScore

5.60

自引率

3.80%

发文量

审稿时长

6-12 weeks

期刊介绍： Pain Practice, the official journal of the World Institute of Pain, publishes international multidisciplinary articles on pain and analgesia that provide its readership with up-to-date research, evaluation methods, and techniques for pain management. Special sections including the Consultant’s Corner, Images in Pain Practice, Case Studies from Mayo, Tutorials, and the Evidence-Based Medicine combine to give pain researchers, pain clinicians and pain fellows in training a systematic approach to continuing education in pain medicine. Prior to publication, all articles and reviews undergo peer review by at least two experts in the field.