Complications of dorsal column stimulation

Abstract

The complications associated with 92 dorsal column stimulator implants are reported. They were of two types, technical and functional. In all there were 58 significant complications. Most technical complications were correctable but complications difficult to correct occurred in 26 patients. Late failure in stimulation was observed in 32 implants that had given excellent pain control for periods ranging from months to years. Improvements in the results of this procedure may be achieved by future technical developments and by clarification of physiological mechanisms.

Histological evaluation of a chronically-implanted electrocorticographic electrode grid in a non-human primate

“…Nevertheless, our findings of meningeal thickening, encapsulation, and fibrosis echo studies on subdural and epidural implants in rats (Henle et al, 2011; Schendel et al, 2013; Schendel et al, 2014) as well as in long-term (> 1 year) subdural and epidural implants in humans (Nashold and Friedman, 1972; Pineda, 1978; Saitoh et al, 2000; Sillay et al, 2013). There are fewer studies on the health of neural tissue underlying these implants.…”

“…While limited incidents of bleeding, infection, infarction, and functional deficits have been reported in association with these implants, no macroscopic fibrotic growth has been reported in otherwise uncomplicated surgeries (Fountas and Smith, 2007; Van Gompel et al, 2008; Wong et al, 2009). Some longer-term studies (> 1 year) of subdural spinal and cortical stimulators and probes reported encapsulation or dural thickening in the vicinity of the implants (Nashold and Friedman, 1972; Pineda, 1978; Saitoh et al, 2000; Sillay et al, 2013). In rats, just one week after an epidural implantation, connective tissue overgrowth was observed (Schendel et al, 2014; Schendel et al, 2013).…”

The role of spinal cord stimulation in the treatment of chronic pain postlaminectomy

“…Even though thousands of patients have undergone implantation, the majority of the literature concerning SCS consists of retrospective case series. Multicenter trials have been used in some cases, but the literature surrounding SCS has five main concerns: [21] LeRoy [22] Long and Erickson [23] North et al [6] North et al [9] Pineda [24] Probst [25] Ray et al [26] Richardson and Shatin † 1) no prospective studies, 2) no blinding of the patient of observers, 3) no randomization of patients or use of control groups, 4) no placebo-controlled studies, and 5) follow-up duration in most series is short.…”

Postsurgical Pathologies Associated with Intradural Electrical Stimulation in the Central Nervous System: Design Implications for a New Clinical Device

“…Some of the early workers reported acute pathology arising from cerebrospinal fluid (CSF) leakage due to incomplete healing of the durotomy at the implantation site, presenting as subcutaneous swelling around the electrode cable at the traversal point through the dura (Figure 3(b)) [12, 32, 39–41]. In general, CSF leakage is often effectively managed through either a follow-up surgical reapproximation of the dura or by using a temporary lumbar drain CSF diversion method [42].…”