Epidural hematoma following spinal cord stimulator implant

Kloss, Brian T.; Sullivan, Anne‐Marie; Rodríguez, E.

doi:10.1007/s12245-010-0174-z

Cited by 23 publications

(12 citation statements)

References 1 publication

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“…A Tuohy needle had been placed at the T-3 interspace resulting in an inadvertent intramedullary placement of an electrode, with the distal tip at the level of C-2. There is report of significant injury in noncervical spinal cord stimulation, [1][2][3]6,12,13,15,22,29,32 but a paucity of literature studying such injuries in the cervical population.…”

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confidence: 99%

Rate of perioperative neurological complications after surgery for cervical spinal cord stimulation

Chan¹,

Winkler²,

Jacques³

2016

SPI

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OBJECTIVE Cervical spinal cord stimulation (cSCS) is used to treat pain of the cervical region and upper extremities. Case reports and small series have shown a relatively low risk of complication after cSCS, with only a single reported case of perioperative spinal cord injury in the literature. Catastrophic cSCS-associated spinal cord injury remains a concern as a result of underreporting. To aid in preoperative counseling, it is necessary to establish a minimum rate of spinal cord injury and surgical complication following cSCS. METHODS The Nationwide Inpatient Sample (NIS) is a stratified sample of 20% of all patient discharges from nonfederal hospitals in the United States. The authors identified discharges with a primary procedure code for spinal cord stimulation (ICD-9 03.93) associated with a primary diagnosis of cervical pathology from 2002 to 2011. They then analyzed short-term safety outcomes including the presence of spinal cord injury and neurological, medical, and general perioperative complications and compared outcomes using univariate analysis. RESULTS Between 2002 and 2011, there were 2053 discharges for cSCS. The spinal cord injury rate was 0.5%. The rates of any neurological, medical, and general perioperative complications were 1.1%, 1.4%, and 11.7%, respectively. There were no deaths. CONCLUSIONS In the largest series of cSCS, the risk of spinal cord injury was higher than previously reported (0.5%). Nonetheless, this procedure remains relatively safe, and physicians may use these data to corroborate the safety of cSCS in an appropriately selected patient population. This may become a key treatment option in an increasingly opioid-dependent, aging population.

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Rate of perioperative neurological complications after surgery for cervical spinal cord stimulation

Chan¹,

Winkler²,

Jacques³

2016

SPI

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“…The phenomenon of postoperative spinal epidural hematomas after SCS paddle lead implantation, although rare, has been previously reported in the literature [20-23]. The patients in these reports presented with pain in the thoracic dermatomes (including abdominal pain), yet had frank neurologic deficits (e.g., paraplegia, unilateral lower extremity weakness, etc.)…”

Section: Discussionmentioning

confidence: 99%

Immediate Abdominal Pain after Placement of Thoracic Paddle Leads for Spinal Cord Stimulation: A Case Series

Lee

Sadrameli

Desai

et al. 2018

Stereotact Funct Neurosurg

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Background: Spinal cord stimulation (SCS) is a well-established treatment modality for chronic pain. Thoracic radiculopathy has been reported as a complication of SCS paddle lead implantation by several authors and commonly presents as abdominal pain. Methods: We performed a search of all patients who underwent either placement of a new epidural paddle lead electrode or revision of an epidural paddle lead electrode for SCS in the thoracic region from January 2017 to January 2018. We then investigated all cases of immediate postoperative abdominal pain. Results: We identified 7 patients who had immediate postoperative abdominal pain among 86 cases of epidural SCS procedures. Most patients were discharged on postoperative days 1–3. No patients required revisions or removals of their SCS for any reason. Conclusions: We conclude that the etiology of immediate postoperative abdominal pain after thoracic paddle lead implantation for SCS is most likely thoracic radiculopathy. We hypothesize that small, transient epidural hematomas could be the cause of this thoracic radiculopathy. We argue that all patients with immediate postoperative abdominal pain and no other neurologic deficits after thoracic paddle lead implantation for SCS should first be treated conservatively with observation and pain management.

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“…[11][12][13] There is 1 report specifically involving percutaneous cylindrical lead placement. 14 The paucity of reports could be evidence that smaller cylindrical leads may lead to fewer bleeding complications compared with larger paddle-type leads.…”

Section: Discussionmentioning

confidence: 99%

Spinal Epidural Hematoma After Spinal Cord Stimulator Trial Lead Placement in a Patient Taking Aspirin

Buvanendran

Young

2014

Regional Anesthesia and Pain Medicine

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Epidural hematoma following spinal cord stimulator implant

Cited by 23 publications

References 1 publication

Rate of perioperative neurological complications after surgery for cervical spinal cord stimulation

Rate of perioperative neurological complications after surgery for cervical spinal cord stimulation

Immediate Abdominal Pain after Placement of Thoracic Paddle Leads for Spinal Cord Stimulation: A Case Series

Spinal Epidural Hematoma After Spinal Cord Stimulator Trial Lead Placement in a Patient Taking Aspirin

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