Neuromodulation techniques, complications, and troubleshooting

Spinal cord stimulation has become one of the mainstays of chronic treatment for patients in pain units. It is a safe, effective, and reversible technique, although the rate of complications is approximately 30%-40%. The most common complication, despite technological breakthroughs and advances in equipment, continues to be electrode migration, which currently occurs in approximately 13% of cases. The most serious complication is related to neurologic problems after infections in the epidural space. A review of technique-related complications is performed, classifying them into mechanical and biological complications, including the strategies to avoid them, mainly through careful patient selection, correct surgical technique, and good selection of the programmed electrical parameters.