BMJ Case Reports 2018; doi:10.1136/bcr-2018-225813
  • Unexpected outcome (positive or negative) including adverse drug reactions

Significant cephalad lead migration with use of externally powered spinal cord stimulator

  1. Chengyuan Wu3
  1. 1Pain Management, Pain Treatment Centers of America, Little rock, Arkansas, USA
  2. 2Pain Management, Center for Interventional Pain and Spine, Wilmington, Delaware, USA
  3. 3Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr Sameer Jain, paindocsj{at}
  • Accepted 5 September 2018
  • Published 21 September 2018


Spinal cord stimulation has been an effective therapy for treatment of chronic low back pain over the last four decades. Over the years, there have been significant technological advances in the neuromodulation devices. Externally powered neuromodulation devices, that do not require an internal pulse generator (IPG) implantation, have recently been approved for treatment of chronic pain and the data on potential pitfalls and unforeseen complications with these devices is minimal. Here, we report a case of a 60-year-old woman with chronic back pain who underwent the implantation of one of such devices and developed complication that required neurosurgical intervention. The epidural stimulator leads in the patient migrated cranially to the T2 level that required extensive neurosurgical exploration. We believe this is the first reported case of such significant cranial epidural lead migration with the use of neurostimulation devices and demands more research into the safety of externally powered neurostimulation devices.


  • Contributors SJ, MAF and CW all contributed to writing and editing of the manuscript. SJ was responsible for literature search and writing most sections of the manuscript. MAF edited and wrote certain sections of the manuscript. CW was responsible for structuring the manuscript, writing certain sections of manuscript and editing the manuscript. All authors approved the submitted version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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