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脊髓刺激器植入术后即刻出现截瘫:病例报告。

Spinal cord stimulator implantation with immediate post-operative paraplegia: Case report.

作者信息

Mamun Noushad, Dzierzak Ellen, Goon Madison, Delgado-Lebron Joanne

机构信息

Department of Physical Medicine and Rehabilitation at Memorial Healthcare System, Hollywood, FL, USA.

Charles E.Schmidt College of Medicine at Florida Atlantic University, Boca Raton, FL, USA.

出版信息

Interv Pain Med. 2023 May 26;2(2):100251. doi: 10.1016/j.inpm.2023.100251. eCollection 2023 Jun.

Abstract

The most common complication of dorsal column spinal cord stimulator implantation is hardware migration. Spinal cord injury following paddle or percutaneous lead implant is rarely reported, with an overall incidence of 0.42%. This report describes a case of immediate post-operative incomplete paraplegia following implantation of one thoracic paddle electrode to address post-laminectomy pain syndrome. Despite emergent removal of the electrode, post-operative corticosteroids, and a course of inpatient rehabilitation, the patient discharged with persistent incomplete paraplegia. Although there is rare occurrence of spinal cord injury with spinal cord neuromodulation, it is important to recognize risk factors which may lead to similar devastating complications.

摘要

脊髓背柱刺激器植入最常见的并发症是硬件移位。使用片状电极或经皮导线植入后发生脊髓损伤的情况鲜有报道,总体发生率为0.42%。本报告描述了一例在植入一个胸段片状电极以治疗椎板切除术后疼痛综合征后立即出现术后不完全性截瘫的病例。尽管紧急取出了电极、给予了术后皮质类固醇治疗以及进行了一个疗程的住院康复治疗,但患者出院时仍遗留持续性不完全性截瘫。虽然脊髓神经调节导致脊髓损伤的情况罕见,但认识到可能导致类似严重并发症的危险因素很重要。

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Spinal Cord Stimulation.脊髓刺激
Neurosurg Clin N Am. 2019 Apr;30(2):169-194. doi: 10.1016/j.nec.2018.12.003. Epub 2019 Feb 18.
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Spinal Cord Stimulation: Clinical Efficacy and Potential Mechanisms.脊髓刺激:临床疗效与潜在机制
Pain Pract. 2018 Nov;18(8):1048-1067. doi: 10.1111/papr.12692. Epub 2018 Apr 23.
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Spinal cord injury arising in anaesthesia practice.麻醉实践中出现的脊髓损伤。
Anaesthesia. 2018 Jan;73 Suppl 1:43-50. doi: 10.1111/anae.14139.

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