Skin allergic reaction to a spinal cord stimulation (SCS): an analysis of the world literature and a case report

One of the methods of treating chronic pain is the neuromodulatory procedure – spinal cord stimulation (SCS). The mechanism of its operation is not fully understood. The first clinical applications were based on the gate control theory of pain proposed by Melzack and Wall in 1965, which is about the central inhibition of pain by non-painful stimuli [1]. Based on this theory, in March 1967, an American neurosurgeon Norman Shealy, by Th1-Th3 laminectomy, implanted a device for stimulating the posterior columnar spinal column in a 70-year-old patient with a pulmonary pain syndrome. Another mechanism explaining the action of SCS is a segmental blockade of neural transmission of pain stimuli, resulting from local changes in the spinal cord and spinal neurons, which are responsible for the conduction and modulation of pain [2].
The main indication for spinal cord stimulation is neuropathic pain, which arises as a result of nerve compression, trauma, ischemic, metabolic (e.g. diabetic neuropathy) and postinfectious (e.g. postherpetic neuralgia) pain. Spinal cord stimulation is used in CRPS type I and CRPS type II syndromes, after neurosurgical operations in the failed back surgery syndrome and post-laminectomy syndrome, in angina pectoris, multiple sclerosis, peripheral vascular disease, arachnoiditis, shoulder plexus injuries and spinal cord injuries [3].
Neurostimulation is a modern method of treatment using electrical impulses. An electric pulse acting on the nerve cell causes a change in the voltage on its surface, so-called depolarization. Stimulation blocks the pain signal so that it does not reach the brain or is not read by the brain as a sensation of pain. The system for stimulating the core consists of three elements: a pulse generator, an electrode placed in the spinal canal and a connector. Electrical stimulation can stimulate or inhibit the neuronal activity, thanks to which it is possible to obtain a change of pain to cover paraesthesia [4]. Neuromodulation techniques allow to reduce pain sensations and are relatively safe for patients. However, in a small percentage of clinical cases, there is a local allergic reaction of the skin after implantation of a spinal cord analgesic stimulator (SCS). The authors carried out an analysis of the clinical case of a surgical patient undergoing surgery at the Department of Neurosurgery, Neurotraumatology and Children’s Neurosurgery, Antoni Jurasz University Hospital No. 1 in Bydgoszcz, where it...


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