Board Certified Neurosurgeon Brain & Spine Care 860-889-9035
Mark Hornyak, MDBoard Certified Neurosurgeon
Back to Cases

Spine Case

Spinal Cord Stimulator

68 yr-old man with chronic back pain

Description

68 yr-old man with chronic back pain x 13 yrs
Started after fall
Radiates to buttocks
Also with neuropathy causing painful tingling in feet, confirmed on EMG
Underwent lumbar laminectomy 2 years ago by another surgeon without relief of symptoms; surgery made back worse

Gallery

Images

Figure 1MRI lumbar spine T2 sagittal (left) and axial (right) through L4-5 disc space. Shows postoperative change from L4-5 laminectomy. Mild diffuse degeneration. There is no nerve compression evident.
Figure 2CT lumbar spine sagittal (left) and axial (right; bone window upper, tissue with no lower) images showing evidence of prior laminectomy without any significant bony abnormality.
Figure 3X-rays of lumbar spine. Flexion (right) and extension (left) images again demonstrating mild degenerative changes. There is no evidence of instability on these dynamic images.
Figure 4Fluoroscopic procedural image taken in AP plane demonstrating the 2-lead wire electrodes in the midline of the thoracic spine extending from T8-T10. Note that the dark spots are the electrical contacts.
Figure 5Fluoroscopic procedural image taken in the lateral plane demonstrating the 2-lead wire electrodes in the dorsal spinal canal. Again, note that the dark spots are the electrical contacts behind the spinal cord.
Figure 6Screen capture image taken from spinal cord stimulator programming software. Demonstrates the electrodes that, when stimulated, provide the patient's greatest pain relief.
Figure 7Intraoperative fluoroscopic images. Image on the left demonstrates initial placement of the stimulating array, note the retractor at the bottom of the image. Image on the right demonstrates final placement of the stimulating electrode array immediately prior to closure.
Figure 8Postoperative x-ray again demonstrating the placement of the stimulating electrode array within the thoracic spinal canal.
Figure 9Images taken from CT of the chest that was performed nearly 3 years after the procedure. AP scanogram (left) shows the stability of the placement of the electrode array. Note the pulse generator in the bottom left portion of the image. On the right is an axial image showing the stimulating array and the dorsal epidural space as expected.

Information on this site should not be relied upon to make a medical diagnosis or determine treatment for a medical condition. Case examples are educational and de-identified. They do not represent expected outcomes for any individual patient. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice.