A Simple Procedure of Epidural Electrode Lead Replacement through a Tissue Sheath in Spinal Cord Stimulation

Spinal cord stimulation (SCS) is widely performed to treat several types of intractable chronic pain. To maintain lasting SCS, epidural electrode leads must be replaced sometimes due to problems like lead breakage. However, in lead replacement, guiding the new lead to the original position may be difficult because granulation tissue sheath forms around the lead. We encountered a surgical case where we inserted new leads through tissue sheaths forming around the old leads from the epidural space to the thoracolumbar fascia; the lead was smoothly introduced to the original place. This procedure is simpler than previously reported techniques. Here, we report the detailed surgical procedure and review the relevant literature.