Acute thoracic disc heralded by change in spinal cord stimulation pattern: illustrative case

BACKGROUND Spinal cord stimulation (SCS) uses unique electric stimulation parameters to selectively treat specific regions of chronic or refractory back pain. Changing these parameters can lead to spreading paresthesia and/or pain beyond the desired region. OBSERVATIONS A patient with a history of stable, successful SCS treatment presented with acute development of paresthesias that were relieved by reduction of stimulation parameters. The patient required paradoxically lower SCS settings for control of chronic back pain. This presentation prompted further investigation, which revealed a new disc protrusion and cord compression at the level of the paddle lead. LESSONS In patients with SCS, a new onset of back pain accompanied by acute paresthesia that is reversible by reducing the SCS amplitude warrants investigation for new spine pathology.

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Spinal Cord Stimulation for the Treatment of Chronic Back Pain Patients: 500-Hz vs. 1000-Hz Burst Stimulation

Neuromodulation Technology at the Neural Interface ◽

10.1111/ner.12252 ◽

2014 ◽

Vol 18 (1) ◽

pp. 9-12 ◽

Cited By ~ 35

Author(s):

Tony Van Havenbergh ◽

Tim Vancamp ◽

Pieter Van Looy ◽

Sven Vanneste ◽

Dirk De Ridder

Keyword(s):

Spinal Cord ◽

Back Pain ◽

Spinal Cord Stimulation ◽

Chronic Back Pain ◽

Burst Stimulation ◽

Pain Patients

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Novel Spinal Cord Stimulation Parameters in Patients with Predominant Back Pain

Neuromodulation Technology at the Neural Interface ◽

10.1111/ner.12032 ◽

2013 ◽

Vol 16 (4) ◽

pp. 370-375 ◽

Cited By ~ 109

Author(s):

Jeffrey Tiede ◽

Lora Brown ◽

Gennady Gekht ◽

Ricardo Vallejo ◽

Thomas Yearwood ◽

...

Keyword(s):

Spinal Cord ◽

Back Pain ◽

Spinal Cord Stimulation ◽

Stimulation Parameters

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Transthoracic Discectomy for Symptomatic Thoracic Disc Herniation: 2-Dimensional Operative Video

Operative Neurosurgery ◽

10.1093/ons/opy407 ◽

2019 ◽

Vol 17 (4) ◽

pp. E158-E158

Author(s):

Yamaan S Saadeh ◽

Siri S Khalsa ◽

Brandon W Smith ◽

Jacob R Joseph ◽

Rhami F Khorfan ◽

...

Keyword(s):

Spinal Cord ◽

Back Pain ◽

Disc Herniation ◽

Interbody Fusion ◽

Cord Compression ◽

Lower Extremity Muscle ◽

High Clinical Suspicion ◽

Disc Herniations ◽

Thoracic Disc

Abstract Thoracic disc herniations are an infrequent occurrence, but can be a cause of significant myelopathy. Diagnosis typically requires a high clinical suspicion that is confirmed with appropriate imaging. Classically, the transthoracic approach for discectomy is the treatment of choice for symptomatic cases. This video concerns a 48-yr-old woman who presented with worsening mid-back pain and progressive gait difficulty. Her examination was significant for proximal lower extremity muscle weakness, difficulty with tandem gait, and urinary incontinence. Imaging demonstrated a large T7-8 disc herniation causing severe spinal cord compression. The patient underwent T7-8 transthoracic discectomy and interbody fusion. She tolerated the procedure well without complication, and postoperative imaging demonstrated decompression of her spinal cord. On follow-up, she had improved mid-back pain, strength, and ambulatory function. The patient consented to the recording of this surgical video for potential publication.

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Systematic Literature Review of Spinal Cord Stimulation in Patients With Chronic Back Pain Without Prior Spine Surgery

Neuromodulation Technology at the Neural Interface ◽

10.1111/ner.13519 ◽

2021 ◽

Author(s):

Jan M. Eckermann ◽

Julie G. Pilitsis ◽

Christopher Vannaboutathong ◽

Belinda J. Wagner ◽

Rose Province‐Azalde ◽

...

Keyword(s):

Spinal Cord ◽

Back Pain ◽

Literature Review ◽

Spine Surgery ◽

Systematic Literature Review ◽

Spinal Cord Stimulation ◽

Chronic Back Pain

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Faculty Opinions recommendation of High-frequency spinal cord stimulation for the treatment of chronic back pain patients: results of a prospective multicenter European clinical study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718242839.793489811 ◽

2014 ◽

Author(s):

Joan Hester

Keyword(s):

Spinal Cord ◽

Back Pain ◽

Clinical Study ◽

Spinal Cord Stimulation ◽

High Frequency ◽

Chronic Back Pain ◽

Pain Patients

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Comparison of spinal cord stimulation in combination with standard pain treatment versus standard pain treatment only in patients with intractable chronic back pain without previous history of spine surgery

http://isrctn.com/ ◽

10.1186/isrctn10663814 ◽

2020 ◽

Author(s):

Wim Laloo ◽

Wesley Park

Keyword(s):

Spinal Cord ◽

Back Pain ◽

Spine Surgery ◽

Spinal Cord Stimulation ◽

Chronic Back Pain ◽

Pain Treatment ◽

Previous History ◽

History Of

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SenzaTM Spinal Cord Stimulation System for the treatment of chronic back pain

http://isrctn.org/> ◽

10.1186/isrctn96424062 ◽

2013 ◽

Cited By ~ 1

Author(s):

Adnan Al-Kaisy

Keyword(s):

Spinal Cord ◽

Back Pain ◽

Spinal Cord Stimulation ◽

Chronic Back Pain ◽

Stimulation System

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Successful integration of interdisciplinary pain rehabilitation and spinal cord stimulation for chronic naive back pain

Medical & Clinical Research ◽

10.33140/mcr.06.10.01 ◽

2021 ◽

Vol 6 (10) ◽

Keyword(s):

Spinal Cord ◽

Chronic Pain ◽

Back Pain ◽

Case Report ◽

Spinal Cord Stimulation ◽

Interventional Procedure ◽

Therapeutic Option ◽

Rehabilitation Program ◽

Stimulation Parameters ◽

Successful Integration

Spinal cord stimulation for naive back pain is a therapeutic option that is rarely considered, especially when conventional stimulation parameters are used. Interdisciplinary pain rehabilitation program is another less feasible but effective therapeutic approach for the management of chronic pain that is not usually used in conjunction with interventional procedures.This case report presents a successful integration of an interdisciplinary pain rehabilitation program with an interventional procedure spinal cord stimulation using conventional stimulation parameters in a patient with chronic, predominantly nociceptive to nociplastic, naïve back pain.

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Effects of Therapy in Patients Suffering from Chronic Back Pain Treated with Spinal Cord Stimulation

Pain Management Nursing ◽

10.1016/j.pmn.2015.01.004 ◽

2015 ◽

Vol 16 (5) ◽

pp. 672-677 ◽

Cited By ~ 1

Author(s):

Anna Mosiewicz ◽

Elżbieta Rutkowska ◽

Monika Matacz ◽

Barbara Mosiewicz ◽

Robert Kaczmarczyk ◽

...

Keyword(s):

Spinal Cord ◽

Back Pain ◽

Spinal Cord Stimulation ◽

Chronic Back Pain

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Scheuermann's Dorsal Kyphosis and Spinal Cord Compression: Case Report

Neurosurgery ◽

10.1227/00006123-198605000-00020 ◽

1986 ◽

Vol 18 (5) ◽

pp. 628-631 ◽

Cited By ~ 16

Author(s):

David M. Klein ◽

Richard L. Weiss ◽

James E. Allen

Keyword(s):

Spinal Cord ◽

Spinal Cord Compression ◽

Neurological Complications ◽

Cord Compression ◽

Posterior Fixation ◽

Childhood And Adolescence ◽

Disc Protrusion ◽

Scheuermann’S Disease ◽

Scheuermann's Disease ◽

Thoracic Disc

Abstract Although Scheuermann's disease (juvenile dorsal kyphosis) is a common problem of late childhood and adolescence, its potential for neurological complications is not widely appreciated. In rare instances, spinal cord compression appears to be produced by the kyphotic protrusion alone, and we present an example of this unusual problem. Although the results of surgical treatment in this situation cannot be substantiated, anterior spondylotomy and decompression followed by posterior fixation appear to offer the best mechanical relief. Spinal cord compression can also be produced by extradural cysts, with which Scheuermann's disease is frequently associated. Scheuermann's disease also is reported to occur in combination with thoracic disc protrusion, but the coincidence here may be random. Pertinent literature is reviewed.

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