Cervical myelopathy due to an epidural cervical mass after chronic cervical spinal cord stimulation

Stereotact Funct Neurosurg. 2013;91(4):265-9. doi: 10.1159/000346501. Epub 2013 May 7.

Abstract

Background: 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.

Objectives: To report the rare occurrence of cervical myelopathy secondary to an epidural cervical spinal mass after chronic cervical SCS.

Methods: 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.

Results: 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.

Conclusion: 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.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Cervical Vertebrae / diagnostic imaging*
  • Cervical Vertebrae / surgery
  • Epidural Space / diagnostic imaging*
  • Epidural Space / surgery
  • Humans
  • Male
  • Radiography
  • Spinal Cord Compression / diagnostic imaging*
  • Spinal Cord Compression / etiology
  • Spinal Cord Compression / surgery
  • Spinal Cord Diseases / diagnostic imaging
  • Spinal Cord Diseases / therapy
  • Spinal Cord Stimulation / adverse effects*
  • Time Factors