2022 Volume 29 Issue 7 Pages 169-172
We report a patient with morbid obesity in whom pulse generator reimplantation was necessitated by lead break during spinal cord stimulation (SCS) 1 month after its initiation. The patient was a 49-year-old male. For pain of the right foot due to right tibial fracture, which persisted even after cast immobilization, epidural block and analgesic therapy using opioids, were performed, but the effect was unsatisfactory, and the patient consulted our department 3 years after the injury. Since edema and allodynia were observed in addition to pain of the right foot, SCS was performed with a diagnosis of complex regional pain syndrome. A permanent pulse generator was implanted, but it was suddenly de-energized 1 month after the implantation, and as lead breakage was confirmed, the device was replaced. The patient had morbid obesity, and lead breakage is considered to have been caused by excessive load exerted on the lead, as the electrode had to be inserted at a sharp angle, and as the proximal end of the anchor protruded out of the fascia. By confirming that the proximal end of the anchor was fixed inside the fascia at the time of reimplantation, an uneventful course was obtained thereafter.
