Wloch Andreas, Capelle H Holger, Saryyeva Assel, Krauss Joachim K
Department of Neurosurgery, Medical School Hannover, Hannover, Germany.
Stereotact Funct Neurosurg. 2013;91(4):265-9. doi: 10.1159/000346501. Epub 2013 May 7.
Spinal cord stimulation (SCS) is an established treatment for neuropathic pain. Severe long-term complications are rare. Only recently secondary mass lesions associated with chronic stimulation were noted to occur.
To report the rare occurrence of cervical myelopathy secondary to an epidural cervical spinal mass after chronic cervical SCS.
Implantation of a paddle electrode at C2-C4 for chronic neuropathic pain resulted in improvement of pain for several years but it lost its efficacy after 8 years. Myelography and postmyelographic CT detected an epidural mass surrounding the electrode and compressing the spinal cord when cervical myelopathy had developed 17 years after electrode implantation.
The mass which consisted of dense fibrous scar tissue was removed via hemilaminectomy. At postoperative follow-up at 8 months there was no further progression of gait disorder.
Long-term cervical SCS in a rare case may lead to fibrous epidural mass lesions which may not only cause loss of efficacy but which may also result in new neurological deficits.
脊髓刺激（SCS）是一种已确立的治疗神经性疼痛的方法。严重的长期并发症很少见。直到最近才注意到与慢性刺激相关的继发性肿块病变的发生。
报告慢性颈段脊髓刺激后硬膜外颈段脊髓肿块继发颈髓病的罕见病例。
在C2 - C4植入平板电极治疗慢性神经性疼痛，疼痛改善了数年，但8年后失去疗效。在电极植入17年后出现颈髓病时，脊髓造影及脊髓造影后CT检测到电极周围硬膜外肿块并压迫脊髓。
通过半椎板切除术切除了由致密纤维瘢痕组织构成的肿块。术后8个月随访时，步态障碍未进一步进展。
罕见情况下，长期颈段脊髓刺激可能导致硬膜外纤维性肿块病变，这不仅可能导致疗效丧失，还可能导致新的神经功能缺损。
