A Retrospective Case Series of Difficult Percutaneous Dorsal Column Stimulator Epidural Lead Placement for Failed Back Surgery Syndrome

BACKGROUND: Percutaneous dorsal column stimulator lead placement is a well-established procedure for a variety of neuropathic disease processes, including failed back surgery syndrome (FBSS). Although previous spine surgeries and patient-specific pathology can make lead placement difficult, there are very few studies or case reports documented in the literature describing these challenges and outcomes. CASE REPORT: A retrospective electronic medical record chart review was conducted of 6 patients with FBSS who failed more conservative interventional therapies and otherwise multimodal analgesia as deemed by both patient and practitioner. CONCLUSION: Postsurgical changes in the epidural space, including fibrosis and scar tissue formation, made driving leads very challenging and compromised final lead placement as well as number of leads placed. KEY WORDS: Neuromodulation, failed back surgery syndrome, dorsal column stimulation