Case PresentationĪ 57-year-old man with a history of chronic left upper extremity C5–C7 radiculopathies presented to a pain clinic 2 months after implantation of a percutaneous cervical SCS with 3 days of an abrupt increase in left upper extremity pain. ![]() Thereafter, we review SCS lead migration, including symptomatology, diagnosis, and management. In the following section, we describe a case of a patient who experienced an acute loss of SCS efficacy related to lead migration. Infection (3.4–10%), epidural fibrosis (19%), neurologic injury (0.034–0.3%), and tolerance to stimulation are some biological complications that can cause loss of SCS efficacy. Device complications include lead migration (2.1–27%), lead fracture (6–10.2%), electrode disconnection from the implantable pulse generator (IPG 0.4–2.9%), and IPG failure (1.7–3%). Etiologies for loss of efficacy can be divided into either device or hardware complications or biologic complications. Patients may experience decreases in both functional status and quality of life as a result of lost therapeutic efficacy. reported an incidence of loss of efficacy of 13.7%. Loss of efficacy results in a decrease or complete loss of therapeutic stimulation or return to pain levels prior to SCS implantation. ![]() ![]() One such complication is loss of therapeutic efficacy. Although it is generally very safe, SCS implantation does have specific risks and complications. Spinal cord stimulation (SCS) is an effective nonpharmacologic modality indicated for the management of multiple chronic neuropathic pain such as failed back surgery syndrome, complex regional pain syndrome, and painful peripheral neuropathies.
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