====== Spinal cord stimulation complications ======


[[Adverse event]]s associated with [[spinal cord stimulation]] are not common but do occur and can be divided into surgical and [[hardware]] complications. Surgical complications include hematoma, seroma, CSF hygroma, infection, wound dehiscence, dural puncture, and spinal cord injury. Many surgical complications can be avoided by
preoperative medical planning
((Murakami M, Lerman I, Jones R. Spinal cord stimulator complications: Lead migration and malfunction. Challenging cases and complication management in pain
medicine. Cham, Switzerland: Springer, 2018; p. 245–250)).

[[Paddle lead]] migration rate was reported to be about 4.8% and generally believed to be less common than percutaneous filiform lead placement
((Kim DD, Vakharyia R, Kroll H, Shuster A. Rates of lead migration and stimulation
loss in spinal cord stimulation: A retrospective comparison of laminotomy versus
percutaneous implantation. Pain Physician 2011;14:513–524.)).

Spontaneous Ascending Migration of a Paddle Lead
((Paz Solis J, Román Aragón M. Spontaneous Ascending Migration of a Paddle Lead.
Neuromodulation. 2019 Feb 20. doi: 10.1111/ner.12933. [Epub ahead of print]
PubMed PMID: 30786084.
)).

===== Hardware complications =====

Infections associated with S. aureus most likely required (partial) hardware removal. Aggressive surgical treatment including hardware removal shortens the duration of antimicrobial treatment. Clear strategies should be developed to treat hardware-related infections to optimize patient management and reduce health- and economic-related burdens
((van Kroonenburgh I, Tan SKH, Heiden P, Wirths J, Matis G, Seifert H, Visser-Vandewalle V, Andrade P. Incidence and Management of Hardware-Related Wound Infections in Spinal Cord, Peripheral Nerve Field, and Deep Brain Stimulation Surgery: A Single-Center Study. Stereotact Funct Neurosurg. 2023 Dec 5:1-11. doi: 10.1159/000535054. Epub ahead of print. PMID: 38052193.))