Editor-in-Chief: Alaa Abd-Elsayed, MD, PhD
BACKGROUND: Patients with chronic degenerative spinal deformity such as scoliosis often suffer from refractory pain and mechanical limitations which impact their quality of life. After trying conservative therapy, they commonly proceed with surgical intervention which has the potential for postoperative complications and failure. Patients with failed back surgery syndrome (FBSS) often pursue spinal cord stimulator therapy for their symptoms. However, there is a paucity of literature available regarding including neuromodulation as a treatment option for spinal deformity surgery. The patient provided HIPAA compliant consent for the inclusion of their clinical information in this report.
CASE REPORT: This case report highlights a patient with severe scoliosis with no prior surgeries who failed conservative therapies and overall had a high surgical risk due to her comorbidities, including severe osteoporosis. The patient responded well to HF-10 stimulation. Her EQ-5D-3L showed notable improvement in self-care and anxiety depression, and she subjectively indicated significant improvement in her mobility, usual activities (housework, socializing), and pain/discomfort. Her Visual Analog Scale (VAS) scores showed improvement in lower back pain from 8 to 1 and leg pain from 3 to 1 at her 3-month follow-up.
CONCLUSION: Overall, the patient had 90% relief in her back and 100% improvement in her leg pain. This case demonstrates how neuromodulation, specifically HF-10, should be included in the treatment protocol when managing spinal deformity patients who are high risk for surgery.
KEY WORDS: Spinal cord stimulator, virgin back, failed back surgery syndrome, scoliosis