nevro spinal cord stimulator problems

3 min read 06-03-2025

Neuronal spinal cord stimulators (SCS) offer a promising treatment option for chronic pain conditions like failed back surgery syndrome (FBSS), but like any medical device, they come with potential problems and complications. This article will delve into the potential issues associated with SCS systems, helping patients and their families make informed decisions.

Types of Neurostimulator Problems

SCS systems, while effective for many, aren't without potential problems. These can range from minor inconveniences to serious complications requiring further medical intervention. Let's categorize these issues:

1. Device-Related Problems:

Lead Migration or Fracture: The leads (thin wires) that deliver electrical impulses to the spinal cord can shift from their intended position (migration) or break (fracture). This reduces the effectiveness of pain relief and may necessitate revision surgery.
Battery Depletion: The battery powering the SCS has a limited lifespan. Depletion requires a surgical procedure to replace the implanted battery. The frequency of replacement depends on the stimulator's settings and usage.
Infection: Infection at the implant site is a serious concern. Signs include redness, swelling, pain, and fever. Prompt medical attention is crucial to prevent sepsis.
Device Malfunction: While rare, the stimulator itself can malfunction, requiring replacement. This could involve issues with the internal circuitry or software.
Lead Dislodgement: In some cases, the leads can become completely dislodged, rendering the device ineffective and requiring surgical intervention.

2. Procedure-Related Complications:

Bleeding or Hematoma: Bleeding at the implant site during the surgical procedure is a potential risk. A hematoma (a collection of blood outside blood vessels) can cause pressure on nerves and require drainage.
Nerve Damage: Although rare, the surgical procedure carries a small risk of damaging nerves in the area of the implant. This can lead to additional pain or neurological deficits.
Dural Puncture: A dural puncture involves accidental perforation of the dura mater, the tough outer membrane surrounding the spinal cord. This can lead to cerebrospinal fluid leaks and headaches.

3. Stimulation-Related Issues:

Overstimulation: Excessive stimulation can cause paresthesia (abnormal sensations like tingling or burning) or even pain. Adjustments to the stimulator's settings are usually necessary.
Understimulation: Inadequate stimulation may not provide sufficient pain relief. This may require adjustments to the settings or even lead repositioning.
Lead-Induced Pain: The leads themselves can sometimes cause pain, necessitating revision surgery or lead removal.
Changes in Pain Perception: Patients may experience changes in their pain perception, possibly due to nerve adaptation or other factors.

4. Long-Term Effects:

Lead breakage: Leads can break over time due to movement or wear and tear.
Battery failure: Batteries have a finite life span and will eventually need replacement.

Diagnosing Neurostimulator Problems

Diagnosing issues with an SCS system often involves a combination of:

Physical examination: The doctor will assess the implant site for signs of infection or other problems.
Imaging studies: X-rays or CT scans can help visualize the lead position and identify any migration or fracture.
SCS programming evaluation: The doctor will check the stimulator's settings and programming to identify potential issues.

Managing and Treating Neurostimulator Problems

Treatment for SCS problems varies depending on the specific issue. Options include:

Program adjustments: For stimulation-related issues, adjustments to the stimulator's settings may be sufficient.
Revision surgery: Lead migration, fracture, or infection may necessitate revision surgery to reposition or replace leads or the entire system.
Medication: Pain medications or antibiotics may be used to manage pain or treat infection.

Conclusion: Making Informed Choices

Choosing to receive an SCS is a significant decision. Understanding the potential problems associated with the device and the surgical procedure is crucial for making an informed choice. Open communication with your healthcare provider about any concerns is essential for optimizing your treatment experience and managing any potential complications effectively. Remember to regularly schedule follow-up appointments to monitor your device and address any emerging issues promptly.