{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T21:38:30Z","timestamp":1779399510102,"version":"3.53.1"},"reference-count":10,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T00:00:00Z","timestamp":1740700800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pain Practice"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Placement of a spinal cord stimulator (SCS) is a neuromodulatory technique with several indications, including persistent spinal pain syndrome type 2 (PSPS2), painful diabetic neuropathy, non\u2010surgical chronic low back pain, and complex regional pain syndrome. SCS is conventionally placed in a caudal to cranial fashion (anterograde), yet there are cases such that spinal fusion hardware and adhesions prevent this insertion technique.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case Presentation<\/jats:title><jats:p>Our patient is a 57\u2010year\u2010old man with PSPS2 who had extensive spinal fusion and epidural scarring extending from the sacrum to T10. The patient trialed and failed conservative medical management for his PSPS2 pain, with limited options available for pain relief. The decision was made to place the SCS leads in a retrograde manner at C7\u2010T1, which were then threaded to the T10 level, offering the patient complete relief of back pain and &gt;80% of bilateral lower extremity radicular symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Here, we present another case in the literature of a permanently placed SCS performed in the retrograde fashion by an interventional chronic pain physician. Though the technique was off label, the retrograde approach offered the patient significant relief when all other treatment modalities failed. Despite the effective use of the retrograde approach, more studies are needed, including guidelines as to when to offer the retrograde approach for patients with inaccessible anatomy for a typical anterograde technique.<\/jats:p><\/jats:sec>","DOI":"10.1111\/papr.70014","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T13:44:01Z","timestamp":1741700641000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Retrograde cervical insertion of spinal cord stimulator in persistent spinal pain syndrome type 2 in patient with fusion from sacrum to <scp>T10<\/scp>"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6276-9056","authenticated-orcid":false,"given":"Christopher L.","family":"Robinson","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Perioperative, and Pain Medicine, Harvard Medical School Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9545-7852","authenticated-orcid":false,"given":"Corey","family":"Hunter","sequence":"additional","affiliation":[{"name":"Ainsworth Institute of Pain Management  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2794-738X","authenticated-orcid":false,"given":"Vwaire","family":"Orhurhu","sequence":"additional","affiliation":[{"name":"University of Pittsburgh Medical Center  Susquehanna, Williamsport Pennsylvania USA"},{"name":"MVM Health  East Stroudsburg Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan D.","family":"Kaye","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Louisiana State University Health Sciences Center Shreveport  Shreveport Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Jones","sequence":"additional","affiliation":[{"name":"Pain Medicine of the South  Knoxville Tennessee USA"},{"name":"Department of Anesthesiology University of Tennessee  Knoxville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,28]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1046\/J.1525\u20101403.1999.00023.X"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.36076\/ppj.2013\/16\/145"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/PAPR.13322"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/J.1526\u20104637.2012.01365.X"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1213\/XAA.0000000000000506"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/NER.12770"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.WNEU.2011.03.019"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.36076\/ppj.2004\/7\/77"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-196307000-00004"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11916\u2010024\u201001280\u20100"}],"container-title":["Pain Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/papr.70014","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:24:42Z","timestamp":1741739082000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/papr.70014"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,28]]},"references-count":10,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1111\/papr.70014"],"URL":"https:\/\/doi.org\/10.1111\/papr.70014","archive":["Portico"],"relation":{},"ISSN":["1530-7085","1533-2500"],"issn-type":[{"value":"1530-7085","type":"print"},{"value":"1533-2500","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,28]]},"assertion":[{"value":"2025-02-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70014"}}