Description:
<jats:p>Spinal cord stimulation (SCS) has been a therapeutic option for chronic pain for
over 40 years with a common indication being failed back surgery syndrome
(FBSS). This case reports the successful implantation of a spinal cord stimulator in a patient with FBSS and kyphoscoliosis for treatment of radicular pain.
Technical considerations and anatomical difficulties that may be encountered
during placement with kyphoscoliosis will be discussed. This patient had failed
other therapies including oral medications, epidural steroid injections, spinal
surgeries, and physical and aquatic therapies. On physical examination the patient had a severely deformed lumbar spine. Careful review of the spine radiographs and CT scan revealed lead placement might be possible at the level of
T12-L1 or L1-2.
A Medline search did not reveal a case of kyphoscoliosis with radicular pain
treated with SCS. After a successful percutaneous trial, a SCS was implanted.
Fourteen weeks later, the patient reported being pain free with an increased
physical activity level and opioid discontinuation.
Technical considerations with kyphoscoliosis may discourage pain physicians
from attempting SCS. This case illustrates that with careful selection, some of
these patients may be candidates for SCS with good results.
Key words: Spinal cord stimulator, spinal cord stimulation, failed back surgery
syndrome, kyphoscoliosis, back pain, lumbar radiculopathy</jats:p>