![]() ![]() Upon initial evaluation, he described his low back pain as constant, aching, and radiating bilaterally to the top of his hips and down into his bilateral gluteal areas. This pain was debilitating and thus prompted his visit to our clinic. Unfortunately, after the fall, the patient increasingly experienced low back and buttock pain, which was not alleviated by the SCS. The patient was subsequently discharged home with a short course of oxycodone. The patient immediately presented to the emergency department in which hardware failure or fractures was ruled out. ![]() However, about 10+ years after SCS implantation, the patient suffered a fall after tripping on his carpet at home and landing on his sacrum. Specifically, the placement was with an SCS system with a single quadripolar surgical paddle lead (Resume 2®, Medtronic) with a constant voltage (Itrel ®, Medtronic) implantable pulse generator (IPG).Īfter the initial programming, the patient had coverage with paresthesia of his low back (left > right) with > 50% pain relief for several years. After failing extensive conservative management, including multiple physical therapy (PT) sessions, sacral medial branch blocks (MBB) followed by radiofrequency ablation (RFA) for suspect sacroiliitis, the patient underwent placement on spinal cord stimulation (SCS) in 1999. ![]() As a result of his debilitating pain, the patient was forced to retire from work as a carpenter. The pain was constant and increased with activity, especially bending, and twisting his back. Despite initial resolution of his symptoms, he progressively had increasing back pain with radiation to the gluteal area bilaterally. In 1995, he underwent an 元-L5 laminectomy and posterior interbody fusion (PLIF) for lumbar stenosis with grade 2 spondylolisthesis of L4-L5 as per Meyerding classification. His medical history was significant for hypertension, obesity, and hyperlipidemia. A 65-year-old man with a history of chronic low back pain with intense bilateral lower extremity radicular pain was referred to our pain clinic. ![]()
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