先前因硬膜外瘢痕而难以再植入的过度活动脊髓刺激器切除可缓解椎板切除术后综合征。

Pain medicine case reports Pub Date : 2024-03-01
Felip Jezzini Roriz Pina, Emily Sottosanti, Evgeny Bulat, Sravya Madabhushi, Fahed Alrowaily, Linda Kollenburg, Christopher Robinson
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引用次数: 0

摘要

背景:当脊髓刺激(SCS)治疗椎板切除术后综合征(PLS)失败时,通常不移除或移出装置,或者很少,它被重新植入,希望用新的植入物成功。病例报告:我们的患者是一名52岁的男性,有PLS病史,并行L5-S1椎间盘切除术,表现为难治性慢性腰痛。他接受了最初的SCS植入,疼痛明显缓解,但由于不必要的腹部运动刺激而受到限制,8个月后移植。尽管他以前的经验,第二次植入SCS,但由于广泛的硬膜外瘢痕导致体位性头痛,这是自我解决的困难。幸运的是,第二次植入提供了50%的疼痛缓解。结论:我们的病例强调了重新考虑SCS再植入术的重要性,尽管需要更多的研究来定义这部分患者,但这可能使一组特定的个体受益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prior Hypermobile Spinal Cord Stimulator Removal With Difficult Reimplantation due to Epidural Scarring Provides Relief in Postlaminectomy Syndrome.

Background: When spinal cord stimulation (SCS) therapy fails for postlaminectomy syndrome (PLS), oftentimes the device is not removed or explanted, or rarely, it is reimplanted with the hopes of success with a new implant.

Case report: Our patient is a 52-year-old man with a history of PLS treated with L5-S1 discectomy who presented with refractory chronic low back pain. He underwent an initial SCS implant with significant pain relief, but was limited due to unwanted abdominal stimulations with movement and explanted 8 months later. Despite his prior experience, a second SCS was implanted but with great difficulty due to widespread epidural scarring leading to a positional headache, which self-resolved. Fortunately, the second implant provided > 50% pain relief.

Conclusions: Our case highlights the importance of reconsidering an SCS reimplantation which may benefit a select group of individuals, though more research is required to define this subset of patients.

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