Immediate abdominal pain after placement of thoracic paddle leads for spinal cord stimulation: A case series

Jonathan J. Lee, Saeed S. Sadrameli, Virendra R. Desai, Ryan J. Austerman, Dean M. Leonard, Brian D. Dalm

Research output: Contribution to journalArticle

Abstract

Background: Spinal cord stimulation (SCS) is a well-established treatment modality for chronic pain. Thoracic radiculopathy has been reported as a complication of SCS paddle lead implantation by several authors and commonly presents as abdominal pain. Methods: We performed a search of all patients who underwent either placement of a new epidural paddle lead electrode or revision of an epidural paddle lead electrode for SCS in the thoracic region from January 2017 to January 2018. We then investigated all cases of immediate postoperative abdominal pain. Results: We identified 7 patients who had immediate postoperative abdominal pain among 86 cases of epidural SCS procedures. Most patients were discharged on postoperative days 1-3. No patients required revisions or removals of their SCS for any reason. Conclusions: We conclude that the etiology of immediate postoperative abdominal pain after thoracic paddle lead implantation for SCS is most likely thoracic radiculopathy. We hypothesize that small, transient epidural hematomas could be the cause of this thoracic radiculopathy. We argue that all patients with immediate postoperative abdominal pain and no other neurologic deficits after thoracic paddle lead implantation for SCS should first be treated conservatively with observation and pain management.

Original languageEnglish (US)
Pages (from-to)400-405
Number of pages6
JournalStereotactic and Functional Neurosurgery
Volume96
Issue number6
DOIs
StatePublished - Feb 1 2019

Keywords

  • Abdominal pain
  • Paddle electrode
  • Spinal cord stimulation
  • Thoracic radiculopathy

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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