Pseudomeningocele and percutaneous intrathecal lead placement complication for spinal cord stimulator. 2019

Achal Patel, and Ben Kafka, and Mazin Al Tamimi
Division of Neurosurgery, Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA. Electronic address: ap3patel@utmb.edu.

The incidence of symptomatic percutaneous intrathecal subarachnoid lead placement for spinal cord stimulator is almost an unheard of complication in the literature. We present the first case of a spinal cord stimulator implant with a complication of symptomatic intrathecal subarachnoid lead placement with a pseudomeningocele. This complication was found with myelogram and addressed by replacement with a new spinal cord stimulator implant with paddle leads instead of percutaneous leads and obliterating the pseudomeningocele tract. Technique for epidural lead placement is discussed. This case illustrates a spinal cord stimulator implant complication of intrathecal percutaneous lead placement with pseudomeningocele and its recognition and treatment involving replacement of the system while minimizing risk of postoperative cerebrospinal fluid leakage. Intraoperative neuromonitoring and interrogation of the spinal cord stimulator system during implantation are effective tools for accurate epidural lead placement.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D004567 Electrodes, Implanted Surgically placed electric conductors through which ELECTRIC STIMULATION is delivered to or electrical activity is recorded from a specific point inside the body. Implantable Electrodes,Implantable Stimulation Electrodes,Implanted Electrodes,Implanted Stimulation Electrodes,Electrode, Implantable,Electrode, Implantable Stimulation,Electrode, Implanted,Electrode, Implanted Stimulation,Electrodes, Implantable,Electrodes, Implantable Stimulation,Electrodes, Implanted Stimulation,Implantable Electrode,Implantable Stimulation Electrode,Implanted Electrode,Implanted Stimulation Electrode,Stimulation Electrode, Implantable,Stimulation Electrode, Implanted,Stimulation Electrodes, Implantable,Stimulation Electrodes, Implanted
D004599 Electric Stimulation Therapy Application of electric current in treatment without the generation of perceptible heat. It includes electric stimulation of nerves or muscles, passage of current into the body, or use of interrupted current of low intensity to raise the detection threshold of the skin to pain. Electrotherapy,Electrical Stimulation Therapy,Interferential Current Electrotherapy,Therapeutic Electric Stimulation,Therapeutic Electrical Stimulation,Therapy, Electric Stimulation,Electric Stimulation, Therapeutic,Electrical Stimulation, Therapeutic,Electrotherapy, Interferential Current,Stimulation Therapy, Electric,Stimulation Therapy, Electrical,Stimulation, Therapeutic Electric,Stimulation, Therapeutic Electrical,Therapy, Electrical Stimulation
D004824 Epidural Space Space between the dura mater and the walls of the vertebral canal. Epidural Spaces,Space, Epidural,Spaces, Epidural
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013116 Spinal Cord A cylindrical column of tissue that lies within the vertebral canal. It is composed of WHITE MATTER and GRAY MATTER. Coccygeal Cord,Conus Medullaris,Conus Terminalis,Lumbar Cord,Medulla Spinalis,Myelon,Sacral Cord,Thoracic Cord,Coccygeal Cords,Conus Medullari,Conus Terminali,Cord, Coccygeal,Cord, Lumbar,Cord, Sacral,Cord, Spinal,Cord, Thoracic,Cords, Coccygeal,Cords, Lumbar,Cords, Sacral,Cords, Spinal,Cords, Thoracic,Lumbar Cords,Medulla Spinali,Medullari, Conus,Medullaris, Conus,Myelons,Sacral Cords,Spinal Cords,Spinali, Medulla,Spinalis, Medulla,Terminali, Conus,Terminalis, Conus,Thoracic Cords

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