Retrograde spinal cord stimulator lead placement for right L5 radiculopathy.

A 55-year-old Hispanic woman was taken to the operating room (OR) for permanent transcutaneous spinal cord stimulator (SCS) insertion. She had a history of lower back pain, radiating to her right posterior thigh for 5 years. She had an L5/S1 laminectomy in 2007 that did not relieve her pain. She had a successful SCS trial for right L5 radiculopathy in 2008 and had a plate inserted surgically the same year. The SCS was helping her pain; however, the post-op course was complicated due to infection and the device was removed. The patient did not respond well on conservative treatment (opioids and transforaminal steroid injections). The surgeon refused to reinsert a plate due to the high risk of another infection. The possibility of repeated infection in a healthy adult with an uncompromised immune system and the benefits of SCS placement were discussed with the patient: she preferred to do the procedure.