Imaging Considerations for Patients With Chronic Low Back Pain: A Case Report.

Abstract

Background: The incidence of low back pain, a leading cause of global disability, has increased significantly. Spinal cord stimulation (SCS) is US Food and Drug Administration-approved for treating intractable back pain, particularly in patients with prior surgical interventions.

Case report: A 43-year-old woman was referred for SCS implantation following 3 prior lumbar spinal surgeries with continued, right-sided radicular back pain. Additional diagnostic imaging was obtained, and a magnetic resonance imaging with and without contrast revealed a recurrent disc despite 3 lumbar microdiscectomies. The patient was then referred for lumbar spinal fusion, specifically anterior lumbar interbody fusion.

Conclusions: This case underscores the importance of comprehensive imaging and clinical assessment to identify structural abnormalities that may mimic or exacerbate pain. It highlights the need for tailored evaluations to determine SCS candidacy and advocates for careful consideration of imaging modalities in managing chronic low back pain, particularly in patients with a history of failed back surgery.