Safe Implementation of Spinal Cord Stimulation in a Patient With a Ventriculoperitoneal Shunt: A Case Report and Review of Procedural Considerations.

BACKGROUND

Spinal cord stimulation (SCS) is a treatment approved for the management of chronic pain refractory to conservative medical treatment. Ventriculoperitoneal (VP) shunts can pose unique challenges during spinal procedures. This case highlights the careful considerations when evaluating patients with VP shunts for SCS and contributes to the growing body of evidence supporting the safe use of neuromodulation therapies in this medically complex population.

CASE REPORT: A 58-year-old woman with communicating hydrocephalus status post VP shunt placement presented with refractory lower back pain despite conservative medical therapy. Subsequently, the patient had permanent SCS placement under general anesthesia without any complications. At follow-up, the patient reported excellent pain control with no evidence of shunt malfunction or neurological compromise.

CONCLUSIONS

SCS may be safely performed in patients with VP shunts following multidisciplinary evaluation and careful procedural planning. This case adds to the limited literature supporting neuromodulation as a treatment for chronic pain in medically complex patients.