PMC10396390_01
The schematic diagram shows the pain locations, including her back, all four limbs, and face. The numerical rating scale scores for back pain are 8 (red color), and bilateral arms and legs are 5 and 6, respectively (gray color).
2188-4226-10-0203-g001.jpg
PMC10396390_01_2188-4226-10-0203-g001.jpg
g001
A 44-year-old woman had severe pain in her back, all four limbs, and face (Fig. 1).
A: Magnetic resonance image shows disc herniations at C5/6 and C6/7 (thin arrow) and syringomyelia at the Th2 level (thick arrow). B, C: Dynamic magnetic resonance images demonstrate protruding disc herniations compressing the spinal cord (B: retroflexion, C: anteflexion).
2188-4226-10-0203-g002.jpg
PMC10396390_01_2188-4226-10-0203-g002.jpg
g002
Magnetic resonance imaging (MRI) showed cervical disc herniations at C5/6 and C6/7 and syringomyelia at the Th2 level (Fig. 2A). Dynamic MRI demonstrated that the disc hernias protruded and compressed the spinal cord with neck retroflexion (Fig. 2B, C).
A, B: Two percutaneous, 8-contact leads of the first implantation are located at the C3-5 levels (A: anterior-posterior view, B: lateral view). C, D: Two additional percutaneous 8-contact leads of the second implantation are located at the Th8-9 levels (C: anterior-posterior view, D: lateral view). E: Finally, four leads and two implantable pulse generators are implanted.
2188-4226-10-0203-g003.jpg
PMC10396390_01_2188-4226-10-0203-g003.jpg
g003
One month later, two new leads at the C3-5 levels and an implantable pulse generator (Intellis; Medtronic Inc.) were implanted under general anesthesia, referring to the previous X-ray of trial lead placement (Fig. 3A, B). Th8-9 during stimulation with the cervical implanted SCS system showed add-on effects for pain relief of the bilateral legs. Therefore, one month later, an additional SCS system was implanted similarly (Fig. 3C, D). Accordingly, four leads and two implantable pulse generators were implanted (Fig. 3E).