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Wet Tap-Induced Spinal Cord Stimulator Trial Failure in Failed Back Surgery Syndrome: A Case Report Highlighting Intrathecal Drug Delivery for Treatment-Resistant Pain

Year: 2025

Type: article

Abstract: A 59-year-old female with failed back surgery syndrome (FBSS) following multiple lumbar surgeries underwent a spinal cord stimulator (SCS) trial for chronic pain management. However, the trial failed due to severe nausea, vomiting, and postural headaches secondary to unintentional dural puncture (wet tap) during lead placement. This resulted in cerebrospinal fluid (CSF) leakage, low-pressure headaches, and subsequent trial intolerance, necessitating early lead removal. Given her failed response to conservative treatments, neuropathic medications, and systemic opioids, an intrathecal pump (ITP) trial was pursued, yielding 90% pain relief and leading to permanent pump implantation. This case highlights the impact of procedural complications on neuromodulation outcomes and the role of intrathecal drug delivery as an alternative in patients who cannot tolerate SCS.

Source: Cureus

DOI: 10.7759/cureus.85793

Authors: Shivang Patel, Matthew Thomas, Harthik Kambhampati, John Stauffer, Tony El-Hayek

Institutions: Lake Erie College of Osteopathic Medicine, Mercy Health

Language: English

Topic: Pain Management and Treatment

Subfield: Anesthesiology and Pain Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4411201193