Cervical Myelomalacia Diagnosed via Magnetic Resonance Imaging in a Patient With a Spinal Cord Stimulator for Complex Regional Pain Syndrome: A Case Report.

BACKGROUND

Neuromodulation is used to treat chronic pain, especially failed back surgery syndrome (FBSS) and complex regional pain syndrome (CPRS) type 1 and type 2. Until recently, neuromodulation had significant restrictions on magnetic resonance imaging (MRI) usage (4). Our patient provided Health Insurance Portability and Accountability Act of 1996 (HIPAA) compliant consent for the inclusion of his clinical information in this report.

CASE REPORT: A 43-year-old man developed CPRS of his right upper extremity that was treated with an MRI-compatible high frequency spinal cord stimulator (SCS). Two years later, he presented with worsening neck and right upper extremity neuropathic pain. Due to the SCS device being MRI compatible, a cervical MRI was performed and showed severe cervical spinal stenosis at C3-C4 with myelomalacia and adjacent segment disease. The patient underwent posterior cervical decompression spine surgery, and urgent explantation of the SCS device.

CONCLUSION

The patient maintained adequate strength and neurological function without any complications from myelomalacia. There was no delay in care in obtaining the MRI while the patient had the SCS device in place. In conclusion, the use of MRI-compatible devices should become the standard of care for implanting spinal cord stimulators.