title: Percutaneous adjustment method for transversely migrated spinal cord stimulation leads: a technical report.
abstract: Lead migration is the most common complication of spinal cord stimulation (SCS). However, the only corrective method for lead migration is revision surgery, which may cause additional complications. Here, we describe a new technique for adjusting a transversely migrated SCS lead. The medical records of four patients diagnosed with complex regional pain syndrome (n = 3) or failed back surgery syndrome (n = 1) who underwent implantation of percutaneous leads for SCS were retrospectively reviewed. Transverse lead migration was diagnosed radiographically after patients reported recurrence of pain or numbness in treated sites. The guide wire from the SCS implant kit was bent and inserted into the target epidural space using a 14-gauge Tuohy needle. When the guide wire contacted the migrated SCS lead, they were advanced to the correct location under C-arm guidance. After re-adjustment of the SCS lead, good coverage of the electrical stimulation was confirmed. Patients were followed for 9-19 months and they reported satisfactory pain relief and good electrical coverage after adjusting the SCS lead. Here, we describe a new technique for adjusting a transversely migrated SCS lead using a percutaneous epidural approach as a simple, safe, and cost-effective alternative to revision surgery.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Cheju Halla General Hospital, Cheju, Korea.
authors.forename: Sang Yoon
authors.initials: SY
authors.lastname: Jeon
authors.affiliation: Department of Anesthesiology and Pain Medicine, College of Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Ji
authors.affiliation: Department of Anesthesiology and Pain Medicine, College of Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
authors.forename: Sie Hyeon
authors.initials: SH
authors.lastname: Yoo
authors.affiliation: Department of Anesthesiology and Pain Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10 63-ro, Yeoungdeungpo-gu, Seoul, 150-713, Korea.
authors.forename: Jin Young
authors.initials: JY
authors.lastname: Chon
authors.affiliation: Department of Anesthesiology and Pain Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10 63-ro, Yeoungdeungpo-gu, Seoul, 150-713, Korea.
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Jung
authors.affiliation: Department of Anesthesiology and Pain Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10 63-ro, Yeoungdeungpo-gu, Seoul, 150-713, Korea. mhsjshgma@gmail.com.
authors.forename: Ho Sik
authors.identifier: http://orcid.org/0000-0002-9446-7335
authors.initials: HS
authors.lastname: Moon
mesh_terms: D000328:Adult; D004567:Electrodes, Implanted / Q000009:adverse effects*; D004824:Epidural Space / Q000473:pathology; D055111:Failed Back Surgery Syndrome / Q000209:etiology*; D005260:Female; D005548:Foreign-Body Migration / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013116:Spinal Cord / Q000601:surgery; D062187:Spinal Cord Stimulation / Q000009:adverse effects*
keywords: Complication; Lead migration; Percutaneous; Revision surgery; Spinal cord stimulation