Postmyelography Acute Paraplegia in Patients With Spinal Cord Stimulators: Case Series and Review of Literature

César Carballo Cuello; Jay Kumar; Gabriel Flores-Milan; Diego Soto Rubio; Bryan Clampitt; Puya Alikhani

doi:10.14444/8760

Postmyelography Acute Paraplegia in Patients With Spinal Cord Stimulators: Case Series and Review of Literature

Int J Spine Surg. 2025 Jun 12;19(3):312-315. doi: 10.14444/8760.

Authors

César Carballo Cuello¹, Jay Kumar², Gabriel Flores-Milan², Diego Soto Rubio², Bryan Clampitt³, Puya Alikhani²

Affiliations

¹ Department of Neurosurgery and Brain Repair, University of South Florida, Morsani College of Medicine, Tampa, FL, USA cesarcarballo@usf.edu.
² Department of Neurosurgery and Brain Repair, University of South Florida, Morsani College of Medicine, Tampa, FL, USA.
³ University of South Florida, Morsani College of Medicine, Tampa, FL, USA.

PMID: 40345859
DOI: 10.14444/8760

Abstract

Background: Computed tomography (CT) myelography is an important imaging modality utilized in patients who cannot tolerate magnetic resonance imaging (MRI) due to severe artifact or because of the presence of MRI incompatible medical devices. In the setting of thoracic stenosis and a spinal cord stimulator (SCS), it can predispose patients to develop acute weakness and paraplegia after myelography.

Case presentation: We present 2 patients with symptomatic thoracic stenosis who developed acute paraplegia after a CT myelogram. Both patients had SCSs due to a history of back pain and were taken emergently to the operating room for SCS removal and thoracic spine decompression.

Conclusion: To our knowledge, these are the first reported cases of acute paraplegia postmyelography in the presence of an SCS in the thoracic spine. This report serves as an important warning and possible emerging contraindication for ordering CT myelography in patients with thoracic stenosis in the presence of an SCS.

Keywords: CT myelography; acute paraplegia; spinal cord stimulator.

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