Huang Meng, Desai Virendra R, Ho David, Simpson Richard K
Department of Neurosurgery, Houston Methodist Neurological Institute.
Urology, Houston Methodist Hospital.
Cureus. 2017 Jan 30;9(1):e1003. doi: 10.7759/cureus.1003.
Spinal cord stimulation is an effective adjunct to the treatment of a variety of chronic pain syndromes. Complications are relatively low in morbidity and are most often secondary to hardware malfunction/malposition. Infection and undesired dysesthesias represent only a minority of complications. Neuropathic orchalgia and scrotalgia after placement of epidural spinal cord stimulator is a previously unreported morbidity. While alarming, this condition is physiologically benign, causing no neurological or urological dysfunction. The two cases we encountered both occurred during uncomplicated percutaneous trial stimulator placement. Corticosteroid treatment and stimulator activation facilitated resolution of the dysesthesia and allowed completion of the trial in one case, while the other case was refractory and resulted in termination of the trial.
脊髓刺激是治疗多种慢性疼痛综合征的一种有效辅助手段。并发症的发病率相对较低,且大多继发于硬件故障/位置不当。感染和意外的感觉异常仅占并发症的少数。硬膜外脊髓刺激器置入后发生的神经性睾丸痛和阴囊痛是一种此前未报道过的并发症。虽然令人担忧,但这种情况在生理上是良性的,不会引起神经或泌尿系统功能障碍。我们遇到的两例均发生在经皮试验刺激器置入无并发症的过程中。皮质类固醇治疗和刺激器激活促进了感觉异常的缓解,并使其中一例完成了试验,而另一例则难以治疗,导致试验终止。