Percutaneous electrode placement for spinal cord stimulation in a patient with spinal fusion: a technical report.
A spinal cord stimulation (SCS) trial was attempted to alleviate left knee pain in a patient with spinal fusion from T12 to L4. Good paresthesia coverage for the knee pain was attained with SCS. However, while removing the needle used for electrode placement, the needle became fixed in the bony supplementary tissue. Moreover, while attempting to remove the needle using Kelly forceps, the hub of the needle became blocked. Without the hub, we had no choice but to use a pneumatic drill for removing the needle. Accordingly, the supplementary bone tissue was drilled under real-time imaging, using a pneumatic drill with a 3.2-mm drill bit, and another epidural needle was inserted through the hole. We consider that, in patients with spinal fusion, making a borehole with a pneumatic drill for introducing the epidural needle for percutaneous SCS electrode placement may be advisable in order to avoid the above-mentioned difficulties.
Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Pusan, Korea.
Sung-Chun
SC
Park
Kyung-Hoon
KH
Kim
D000368:Aged; D000767:Anesthesia, Epidural / Q000379:methods*; D004599:Electric Stimulation Therapy / Q000295:instrumentation / Q000379:methods*; D004567:Electrodes, Implanted; D055111:Failed Back Surgery Syndrome / Q000628:therapy; D006801:Humans; D007719:Knee Joint / Q000294:innervation; D008297:Male; D009339:Needles; D059408:Pain Management / Q000379:methods; D013116:Spinal Cord / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods