Spinal stimulator peri-electrode masses: case report.
The authors describe a case of delayed spastic quadriparesis caused by a peri-electrode mass following the implantation of a minimally invasive percutaneous spinal cord stimulator (SCS). Prior reports with paddle-type electrodes are reviewed, and a detailed histological and pathophysiological comparison with the present case is made. The patient developed tolerance to a cervical percutaneous SCS 4 months after implantation, followed by the onset of spastic quadriparesis 9 months after implantation. The stimulator was removed, and contrast-enhanced MRI revealed an enhancing epidural mass where the system had been placed, with severe spinal cord compression. Decompression was carried out, and the patient experienced neurological improvement. Pathological examination revealed fibrotic tissue with granulomatous and multinucleated giant cell reactions. No evidence of infection or hemorrhage was found. Professionals treating patients with SCSs or contemplating their insertion should be aware of this delayed complication and associated risk factors.
Department of Neurosurgery, Houston Methodist Neurological Institute; and.
Robert A
RA
Scranton
Ioannis M
IM
Skaribas
Richard K
RK
Simpson
D000328:Adult; D017586:Diskectomy; D004599:Electric Stimulation Therapy / Q000009:adverse effects*; D004567:Electrodes, Implanted / Q000009:adverse effects*; D004824:Epidural Space / Q000473:pathology; D005260:Female; D006099:Granuloma / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D019547:Neck Pain / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D010148:Intractable Pain / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D013117:Spinal Cord Compression / Q000209:etiology* / Q000601:surgery; D013123:Spinal Fusion
SCS = spinal cord stimulator; complication; electrode mass; epidural mass; myelopathy; spinal stimulation; technique