The patients shown below represent a group of individuals whose quality of life has been enhanced by the use of implanted spinal neurostimulators for the relief of pain for 2 decades or more. All of these individuals experienced intractable pain from adhesive arachnoiditis caused by past Pantopaque® myelography. The typical reason for being seen again related to neurostimulator component malfunction requiring revision of the system or optimization of the pulse generators. All of these patients have RF coupled systems as opposed to totally implanted (with batteries) neurostimulators. Following treatment all of these patients continued to have good results. They have kindly given permission to be identified personally so that others can benefit from their experience.
21 years after first neurostimulator implant. The entire system was replaced. Microsurgical dissection allowed the epidural electrode assembly to be removed from its pocket and replaced with a similar electrode.
This patient had his RF receiver placed in a subclavicular pocket 19 years previously (shown above). His new receiver was placed in a anterior chest wall subcutaneous pocket.
Mary K. Simoni
This patient’s original electrode assembly was bipolar (implanted in 1978) and was left in. Her revised system’s present electrode assembly is multi-polar and shown above it.
Seen in 2000 for optimization of neurostimulator. Original implant was in 1978 with revision in 1993. Present electrodes are shown by the red dots. The yellow dot is over the 1993 RF receiver. The green dot is over another implanted neurostimulator (cardiac pacemaker with internal batteries).
Had a bipolar intradural (endodural) dorsal cord neurostimulator implanted for the relief of intractable pain secondary to adhesive arachnoiditis in 1978. In the composite image above the spinal electrode and RF receiver located in the left subclavicular area are shown. After 22 years of daily use the system began to malfunction and required replacement. The third image shows the 22 year old electrode after removed from the dural pocket. The quality of the dura under the electrode is pristine. The last image shows the new system in place with a multi-contact pad electrode assembly and the RF receiver in a anterior chest wall position. Mr. Slater’s new RF system has greater versatility and better pain relief than his previous system.