Abrupt Loss of Spinal Cord Stimulation After Trauma: A Case-Based Approach to Evaluation and Management.

Spinal cord stimulation (SCS) is an established therapy for refractory neuropathic pain following lumbar spine surgery and frequently allows for meaningful pain reductio, functional improvement, and minimizing reliance on pharmacotherapy and opioids. Despite its efficacy, hardware-related complications remain an important cause of treatment failure. We present a fictional teaching case of a 68-year old man with persistent bilateral radicular pain after lumbar decompression who experienced 80% relief following SCS implantation. Eight months later, after a motor vehicle collision, he developed abrupt loss of stimulation coverage and recurrence of severe neuropathic symptoms. This teaching case discusses appropriate next steps for evaluation and management in this particular clinical scenario.