1269. Cephalad Migration of a Percutaneous Spinal Cord Stimulator Lead

Authors: Brian Patrick Curry, MD; Nicholas Szuflita, MD; George Rymarczuk, MD; Ali Turabi, MD (Bethesda, MD)

Introduction:

Spinal cord stimulation is an effective therapy for pain control in select patients. Lead migration is among the most common complications associated with the procedure, with the most common directions of migration being anterolateral or caudal.

Methods:

Here we report the case of cephalad migration of a percutaneously-placed spinal cord stimulator lead in a patient who presented with acute loss of coverage 4 months postoperatively.  

Results:

A 46-year-old man presented with sudden return of his symptoms four months after implantation of a percutaneously-placed spinal cord stimulator lead. Imaging demonstrated cephalad migration of the lead. The device was successfully re-programmed in order to regain coverage, thus avoiding a return to the operating room for revision.  There was no unwanted stimulation as a result of reprogramming. 

Conclusion:

This case represents the second reported incidence in the medical literature of cephalad migration of a spinal cord stimulator lead.  It is the first reported incidence of migration of a percutaneously-placed lead, as well as the first incidence of successful reprogramming without return to the operating room.