title: Trial spinal cord stimulator reimplantation following lead breakage after third birth.
abstract: BACKGROUND
  Many studies have reported lead migration and breakage as complications of epidural spinal cord stimulation. In cases where rapid changes in physique such as those caused by pregnancy are expected, it is unclear whether extra consideration regarding possible adjustments and care to avoid complications such as lead breakage are required.
  
  
  OBJECTIVE
  This article presents a case in which spinal cord stimulation was used to manage these complications in a woman during the perinatal period.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Pain management clinic.
  
  
  METHODS
  The patient was a 36-year-old female, approximate weight of 100 pounds, and 5-foot 1 inch in height, whose chief complaint was lower back and bilateral leg pain. The pain could not be alleviated by conservative therapies such as nerve blockade, oral medications with non-steroidal anti-inflammatory drugs, antidepressants, anticonvulsants or physical therapy. A spinal cord stimulator was implanted at another facility, which relieved the pain. The patient subsequently had 2 vaginal births without any problems relating to the stimulation sites, and both infants were healthy. She experienced lead breakage after the third vaginal birth that led to the subsequent reimplantation procedure.
  
  
  RESULTS
  The patient had 2 subsequent vaginal births following the initial implantation with no problems related to the stimulation sites, and both infants were healthy. At age 34, following her third vaginal birth, the stimulator became ineffective and was removed. The withdrawn lead wire was found to be broken in 2 places.
  
  
  CONCLUSIONS
  A case report.
  
  
  CONCLUSIONS
  Pregnancy following implantation of a spinal cord stimulator might result in lead breakage as abdominal girth increases. The present case exemplifies how pregnancy following implantation of a spinal cord stimulator might cause lead breakage as abdominal girth increases. Extra care is required to prevent lead breakage when anchors are fixed.
authors.affiliation: Faculty of Medicine Yufu, Oita University, Oita, Japan. ntake@oita-u.ac.jp
authors.forename: Naozumi
authors.initials: N
authors.lastname: Takeshima
authors.forename: Kentaro
authors.initials: K
authors.lastname: Okuda
authors.forename: Junji
authors.initials: J
authors.lastname: Takatanin
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hagiwra
authors.forename: Takayuki
authors.initials: T
authors.lastname: Noguchi
mesh_terms: D000328:Adult; D004599:Electric Stimulation Therapy / Q000009:adverse effects* / Q000295:instrumentation; D004567:Electrodes, Implanted / Q000009:adverse effects*; D004868:Equipment Failure; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology / Q000503:physiopathology* / Q000517:prevention & control; D012086:Reoperation / Q000379:methods*; D013116:Spinal Cord / Q000033:anatomy & histology / Q000502:physiology*