Download PDF
J Neurol Surg Rep 2016; 77(02): e67-e72
DOI: 10.1055/s-0036-1579631
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Osteolysis and Cervical Cord Compression Secondary to Silicone Granuloma Formation around a Dorsal Spinal Cord Stimulator: A Case Report

John R. Dimar II
1   Norton Leatherman Spine Center, Louisville, Kentucky, United States
,
David T. Endriga
1   Norton Leatherman Spine Center, Louisville, Kentucky, United States
,
Leah Y. Carreon
1   Norton Leatherman Spine Center, Louisville, Kentucky, United States
› Author Affiliations
Further Information

Publication History

13 October 2015

30 December 2015

Publication Date:
17 May 2016 (online)

   Permissions and Reprints

Abstract

Spinal cord stimulators (SCSs) have long been in use as a modality for the management of numerous pain pathologies. Along with commonly anticipated morbidities such as displacement, failure (due to fracture or breakage), or infection, there have also been rare but well-documented complications of fibrous scarring, resulting in spinal cord compression. This is the first known case that demonstrates osteolysis and bony destruction of the vertebrae adjacent to the SCS along with the foreign-body granulomatous reaction. A 61-year-old man who underwent prior posterior cervical implantation with an SCS followed by multiple revisions presented with progressive paresthesias, numbness, and weakness of his upper extremities 10 years later. The SCS was removed followed by decompression, and instrumented fusion of the cervical spine. Histopathologic analysis reveals foreign-body reaction to the SCS and its silicone debris. Tissue cultures were negative for bacterial, fungal, or mycobacterial infection. No malignancy was seen. The current case illustrates the inherent possibility of foreign-body granulomatous reactions with SCS and its silicone particulate matter, made unique in this instance by the associated bony destruction of the adjacent vertebrae.

Keywords

spinal cord stimulator complications - silicone granuloma - osteolysis secondary to silicone implants
 

  • References

  • 1 Bendersky D, Yampolsky C. Is spinal cord stimulation safe? A review of its complications. World Neurosurg 2014; 82 (6) 1359-1368
    CrossrefPubMedGoogle Scholar
  • 2 Cicuendez M, Munarriz PM, Castaño-Leon AM, Paredes I. Dorsal myelopathy secondary to epidural fibrous scar tissue around a spinal cord stimulation electrode. J Neurosurg Spine 2012; 17 (6) 598-601
    CrossrefPubMedGoogle Scholar
  • 3 Dam-Hieu P, Magro E, Seizeur R, Simon A, Quinio B. Cervical cord compression due to delayed scarring around epidural electrodes used in spinal cord stimulation. J Neurosurg Spine 2010; 12 (4) 409-412
    CrossrefPubMedGoogle Scholar
  • 4 Lennarson PJ, Guillen FT. Spinal cord compression from a foreign body reaction to spinal cord stimulation: a previously unreported complication. Spine 2010; 35 (25) E1516-E1519
    CrossrefPubMedGoogle Scholar
  • 5 Reynolds AF, Shetter AG. Scarring around cervical epidural stimulating electrode. Neurosurgery 1983; 13 (1) 63-65
    CrossrefPubMedGoogle Scholar
  • 6 Scranton RA, Skaribas IM, Simpson Jr RK. Spinal stimulator peri-electrode masses: case report. J Neurosurg Spine 2015; 22 (1) 70-74
    CrossrefPubMedGoogle Scholar
  • 7 Wada E, Kawai H. Late onset cervical myelopathy secondary to fibrous scar tissue formation around the spinal cord stimulation electrode. Spinal Cord 2010; 48 (8) 646-648
    CrossrefPubMedGoogle Scholar
  • 8 Altmeyer MD, Anderson LL, Wang AR. Silicone migration and granuloma formation. J Cosmet Dermatol 2009; 8 (2) 92-97
    CrossrefPubMedGoogle Scholar
  • 9 Bassetto F, Scarpa C, Caccialanza E, Montesco MC, Magnani P. Histological features of periprosthetic mammary capsules: silicone vs. polyurethane. Aesthetic Plast Surg 2010; 34 (4) 481-485
    CrossrefPubMedGoogle Scholar
  • 10 Lopiccolo MC, Workman BJ, Chaffins ML, Kerr HA. Silicone granulomas after soft-tissue augmentation of the buttocks: a case report and review of management. Dermatol Surg 2011; 37 (5) 720-725
    CrossrefPubMedGoogle Scholar
  • 11 Joyce TJ. Re: Grading of radiographic osteolytic changes after Silastic metacarpophalangeal arthroplasty and a prospective trial of osteolysis following use of Swanson and Sutter prostheses. J Hand Surg Eur Vol 2007; 32 (2) 236-237 , author reply 237
    PubMedGoogle Scholar
  • 12 Hirakawa K, Bauer TW, Culver JE, Wilde AH. Isolation and quantitation of debris particles around failed silicone orthopedic implants. J Hand Surg Am 1996; 21 (5) 819-827
    CrossrefPubMedGoogle Scholar
  • 13 Kistler U, Weiss AP, Simmen BR, Herren DB. Long-term results of silicone wrist arthroplasty in patients with rheumatoid arthritis. J Hand Surg Am 2005; 30 (6) 1282-1287
    CrossrefPubMedGoogle Scholar
  • 14 Lemperle G, Gauthier-Hazan N, Wolters M, Eisemann-Klein M, Zimmermann U, Duffy DM. Foreign body granulomas after all injectable dermal fillers: part 1. Possible causes. Plast Reconstr Surg 2009; 123 (6) 1842-1863
    CrossrefPubMedGoogle Scholar
  • 15 Anastassov GE, Schulhof S, Lumerman H. Complications after facial contour augmentation with injectable silicone. Diagnosis and treatment. Report of a severe case. Int J Oral Maxillofac Surg 2008; 37 (10) 955-960
    CrossrefPubMedGoogle Scholar
  • 16 Dragu A, Theegarten D, Bach AD , et al. Intrapulmonary and cutaneous siliconomas after silent silicone breast implant failure. Breast J 2009; 15 (5) 496-499
    CrossrefPubMedGoogle Scholar