Late Spontaneous Migration of a Dorsal Column Stimulator Paddle Lead.
The most frequently encountered complication of dorsal column stimulators is lead migration. The vast majority of these events are seen in the first few weeks to months. Late paddle lead migration is a very uncommon occurrence in this setting. We describe a case of a 51-year-old male with a history of reflex sympathetic dystrophy having undergone dorsal column stimulator insertion at the level of C1-C2. A good clinical benefit was appreciated in the postoperative period once the stimulator was turned on. Approximately six months postoperatively, the patient suddenly lost coverage. Radiographic imaging revealed that the lead had migrated caudally to the C3-C4 level. Subsequent revision surgery took place. This description highlights a common complication, but occurring outside the expected time frame after surgery.
School of Osteopathic Medicine, Des Moines University.
Chao
C
Li
Neurosurgery, SUNY Upstate Medical University.
Michael A
MA
Galgano
Neurosurgery, SUNY Upstate Medical University.
David A
DA
Carter
cervical spine; complex regional pain syndrome; dorsal colum stimulation; dorsal column stimulator; late lead migration; late paddle lead migration; lead migration; paddle lead migration; reflex sympathetic dystrophy; spine surgery
Expert Rev Neurother. 2004 May;4(3):479-90
15853544
J Neurosurg. 1991 Sep;75(3):402-7
1869942
J Neurosurg. 2004 Mar;100(3 Suppl Spine):254-67
15029914
Spine (Phila Pa 1976). 1996 Dec 1;21(23):2786-94
8979327
Science. 1965 Nov 19;150(3699):971-9
5320816
Neuromodulation. 2012 Mar-Apr;15(2):118-23; discussion 123
22074412
Neuromodulation. 2012 Jul;15(4):392-401
22672129
Pain Physician. 2011 Nov-Dec;14(6):513-24
22086092
Neuromodulation. 2012 Jul;15(4):402-7
22672364
Acta Neurochir Suppl. 2007;97(Pt 1):85-9
17691361
Pain Physician. 2002 Apr;5(2):156-66
16902666
Neuromodulation. 2011 Jul-Aug;14(4):319-24; discussion 324-5
21992425
Int J Technol Assess Health Care. 2005 Summer;21(3):351-8
16110715
Neuromodulation. 2013 Nov-Dec;16(6):537-45; discussion 545
23294166
Neuromodulation. 2011 Sep-Oct;14(5):412-22; discussion 422
21967534