Post-dural Puncture Headache After Removal of Trail Spinal Cord Stimulator Leads: A Case Report

Spinal cord stimulators (SCS) have been an invaluable resource in treating chronic pain pathologies such as failed back surgery syndrome, complex regional pain syndrome, neuropathic pain, and leg ischemia. Post-dural puncture headaches (PDPH) are a common phenomenon that happens when the dura is compromised. It has been seen with permanent SCS placement, but less commonly reported with SCS trail leads. We present a case of a patient who developed PDPH symptoms, not after initial trial leads placement but upon their removal. This case not only illustrates that dural compromise can occur when the placement of the leads is correct with confirmatory imaging, but also the leads themselves can contribute to masking the defect.

[1]  R. D'souza,et al.  Incidence and Predictors of Inadvertent Dural Puncture After Percutaneous Spinal Cord Stimulation: A Retrospective Data Base Analysis. , 2022, Neuromodulation : journal of the International Neuromodulation Society.

[2]  O. Viswanath,et al.  Dural Puncture During Spinal Cord Stimulator Lead Insertion: Analysis of Practice Patterns , 2022, Anesthesiology and pain medicine.

[3]  H. Shin Recent update on epidural blood patch , 2022, Anesthesia and pain medicine.

[4]  R. Russell,et al.  Treatment of obstetric post-dural puncture headache. Part 1: conservative and pharmacological management. , 2019, International journal of obstetric anesthesia.

[5]  K. Slavin,et al.  The Neurostimulation Appropriateness Consensus Committee (NACC) Safety Guidelines for the Reduction of Severe Neurological Injury , 2017, Neuromodulation : journal of the International Neuromodulation Society.

[6]  T. Simopoulos,et al.  The Incidence and Management of Postdural Puncture Headache in Patients Undergoing Percutaneous Lead Placement for Spinal Cord Stimulation , 2016, Neuromodulation (Malden, Mass.).

[7]  E. Buchser,et al.  Complications of Spinal Cord Stimulation and Peripheral Nerve Stimulation Techniques: A Review of the Literature. , 2015, Pain medicine.

[8]  R. Lipton,et al.  Post‐Dural Puncture Headache: Part I Diagnosis, Epidemiology, Etiology, and Pathophysiology , 2010, Headache.

[9]  R. H. Rho,et al.  Management of Cerebral Spinal Fluid Leak Complicating Spinal Cord Stimulator Implantation , 2006, Pain practice : the official journal of World Institute of Pain.