Retrograde Epidural Spinal Cord Stimulation for the Treatment of Intractable Neuropathic Pain Following Spinal Cord and Cauda Equina Injuries: A Case Report and Literature Review

Spinal cord stimulation (SCS) is a treatment option for pain that hasn't responded to other therapies. It works by stimulating the spinal cord to reduce pain signals. Typically, SCS electrodes are placed in an anterograde manner (from caudal to rostral). In this case, the authors describe a retrograde placement due to epidural fibrosis. A patient with neuropathic pain from spinal cord and cauda equina injuries experienced significant pain relief after a trial of SCS with a retrograde placement.

• 1
  Retrograde epidural SCS is a feasible option for patients with extensive epidural fibrosis or aberrant vertebral anatomy.
• 2
  The patient in this case experienced a 50 to 70% reduction in neuropathic pain after permanent stimulator implantation.
• 3
  Retrograde placement allows electrode insertion at desired levels, especially with epidural fibrosis or unsuitable skin conditions for anterograde approach.