Patel Shivang, Ibrahim Jalal, Habib Feross, Kambhampati Harthik, El-Hayek Tony
College of Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, USA.
Interventional Pain Management, Mercy Health-Allen Hospital, Oberlin, USA.
Cureus. 2025 Aug 3;17(8):e89281. doi: 10.7759/cureus.89281. eCollection 2025 Aug.
Spinal cord stimulation (SCS) has demonstrated efficacy in treating intractable pain associated with failed back surgery syndrome (FBSS), though its success in patients with severe spinal deformities remains uncertain. This case report presents a 78-year-old female patient with FBSS, advanced lumbar scoliosis, and multiple prior spinal surgeries, who experienced severe, debilitating pain despite extensive conservative and pharmacological treatments. Imaging revealed significant degenerative changes, spinal subluxations, and multilevel stenosis. After a successful SCS trial with 70-80% pain relief and full restoration of activities of daily living (ADLs), a nonrechargeable SCS system (Vanta) was implanted. Despite anatomical challenges, optimized electrode placement and programming adjustments resulted in sustained pain reduction and functional improvement. This case illustrates the potential feasibility of SCS in the setting of complex spinal pathology and emphasizes the value of individualized treatment planning. While not broadly generalizable, it contributes to the growing body of evidence supporting carefully selected use of SCS in anatomically challenging patients.
脊髓刺激（SCS）已被证明在治疗与腰椎手术失败综合征（FBSS）相关的顽固性疼痛方面有效，但其在严重脊柱畸形患者中的成功率仍不确定。本病例报告介绍了一名78岁患有FBSS、重度腰椎侧弯且曾多次接受脊柱手术的女性患者，尽管接受了广泛的保守治疗和药物治疗，仍经历着严重的、使人衰弱的疼痛。影像学检查显示有明显的退行性改变、脊柱半脱位和多节段狭窄。在成功进行SCS试验，疼痛减轻70 - 80%且日常生活活动（ADL）完全恢复后，植入了一个不可充电的SCS系统（Vanta）。尽管存在解剖学上的挑战，但通过优化电极放置和编程调整，实现了持续的疼痛减轻和功能改善。本病例说明了SCS在复杂脊柱病理情况下的潜在可行性，并强调了个体化治疗计划的价值。虽然不能广泛推广，但它为越来越多支持在解剖学上具有挑战性的患者中谨慎选择使用SCS的证据做出了贡献。
