Spinal Cord Stimulation in Adult Tethered Cord Syndrome: Case Report and Review of the Literature.

Abstract

Spinal cord stimulation (SCS) is an evidence-based treatment for chronic neuropathic pain; however, there is a dearth of evidence investigating this modality in patients with tethered cord syndrome. We present a case of 55-year-old woman with history of lipo-myelomeningocele repair and multiple detethering surgeries who presented with chronic low back and leg pain accompanied by progressive gait dysfunction. After a successful trial, she underwent SCS paddle lead placement that resulted in decrease of her visual analog scale for pain from 9/10 to 0-2/10 as well as daily opioid intake from 90 to 199 mg morphine-equivalent doses to 40 to 60 mg morphine-equivalent doses. On last follow-up she reported 70%-85% relief of her low back and leg pain, better ambulation, and improved quality of life. The literature review identified 2 other case reports of SCS in tethered cord syndrome with similar improvement in pain alleviation.