Your spinal cord stimulator leads moved and the pain relief stopped — was that a surgical failure?
This article explains what surgeons are required to do to prevent lead migration, where the procedure commonly goes wrong, and how to work out whether what happened to you was avoidable.
What the surgeon was required to do
Spinal cord stimulation works by placing electrode leads at a precise location in the epidural space. The Precision Spectra system — manufactured by Boston Scientific — uses percutaneous or paddle leads that must be anchored securely at the time of implantation. Published clinical guidelines and the device’s own instructions for use require the implanting surgeon to fix the leads with anchoring sutures, position them at the correct spinal level, and verify placement under fluoroscopic imaging before closing. The surgeon must also counsel the patient about movement restrictions during the healing period.
A patient with chronic lumbar pain received a Precision Spectra permanent implant. The trial had provided 80% pain relief. Six weeks after surgery, she noticed the familiar tingling had shifted — it no longer covered her lower back. A plain X-ray showed the leads had migrated two vertebral levels upward. The surgeon told her lead migration was a known complication. He did not tell her that the anchoring suture had pulled free, or that the operative note recorded only a single anchor point where two were indicated.
The anchor was placed incorrectly — or not at all
The most direct cause of lead migration is inadequate anchoring at the time of surgery. The implanting surgeon secures the lead to the fascia using a strain-relief loop and one or more anchor sutures. When the surgeon places too few anchors, positions them too close to the lead tip, or fails to create an adequate strain-relief loop, the lead moves the first time the patient bends or twists.
This is not a complication the patient causes. The lead moves because the surgeon did not fix it properly.
The surgeon implanted at the wrong spinal level
Correct lead placement requires the surgeon to identify the target vertebral level under live fluoroscopy and confirm the position before anchoring. When the surgeon misidentifies the level — or places the lead at a level that provides coverage during the prone operative position but not in normal posture — the patient wakes from surgery with apparent coverage that disappears within days.
The surgeon then attributes the loss of coverage to migration. In some cases, the lead never moved. It was never in the right place.
The surgeon failed to warn about the real risk of migration
Patients consenting to spinal cord stimulator implantation must receive specific information about lead migration — including the rate for percutaneous leads, which published data places between 13% and 22%, and the factors that increase individual risk. A surgeon who obtains consent by describing migration as a rare possibility, without disclosing the patient’s specific risk profile or the steps taken to minimise it, has not obtained valid consent.
When migration then occurs, the patient had no opportunity to weigh that risk against alternatives — including a paddle lead, which carries a substantially lower migration rate.
- Your pain coverage changed or disappeared within weeks or months of the permanent implant, and imaging confirmed the leads had shifted position.
- You were told lead migration is a known complication, but nobody explained what the surgeon did — or did not do — to prevent it in your case.
- Your operative note or discharge summary mentions a single anchor point, no strain-relief loop, or does not record fluoroscopic confirmation of lead position.
- The surgeon recommended revision surgery to reposition the leads, but did not explain why they moved in the first place.
- You were not told before surgery that percutaneous leads carry a significantly higher migration rate than paddle leads, and that your anatomy or activity level made you a higher-risk candidate.
- You had a successful trial but the permanent implant never provided the same coverage — suggesting the permanent leads were not placed at the same level as the trial leads.
The records — the operative note, the fluoroscopy images, the anchoring documentation — will answer these questions more reliably than anyone’s recollection. Many people wait before looking into this, sometimes years after the revision surgery. The time limit for making a claim varies by state and territory in Australia, and it matters.
What a legal review of the records involves
A medical negligence review of a spinal cord stimulator case starts with the operative records — the implant report, the fluoroscopy images, the anchoring technique documented in the notes, and the consent form. Those records are compared against the device instructions for use, published clinical guidelines, and the standard expected of a competent implanting surgeon.
The goal is a straight answer: was the migration caused by a failure in surgical technique or consent, or does the evidence suggest it fell within the range of outcomes a careful surgeon could not have prevented?
Not sure whether your lead migration was avoidable?
Dr Rosemary Listing reviews the records and gives you a straight answer. No obligation, no pressure — just clarity.
For more information about how medical negligence claims work in Australia, visit Reframe Legal — Medical Negligence.
Dr Rosemary Listing is a lawyer specialising in medical negligence claims, with a PhD in medical negligence. She practises through Peter Evans & Associates, servicing clients across Australia.
Her legal background allows her to read medical records — and then apply the law to what she finds. For spinal cord stimulator lead migration cases, that perspective matters: the failures that cause harm often sit in the gap between what the operative note records and what the patient was told.
Dr Listing’s work is focused on giving people an honest answer about whether what happened to them was avoidable. Many people wait a long time before looking into it. She understands why and applies a sensitive and caring approach to all her clients’ cases.
- Boston Scientific Corporation, Precision Spectra Spinal Cord Stimulator System — Instructions for Use (current edition), including lead anchoring and implantation technique requirements.
- Deer TR et al, ‘The Appropriate Use of Neurostimulation of the Spinal Cord and Peripheral Nervous System for the Treatment of Chronic Pain and Ischemic Diseases: The Neuromodulation Appropriateness Consensus Committee’, Neuromodulation (2014) 17(6): 515–550.
- Eldabe S et al, ‘Complications of Spinal Cord Stimulation and Peripheral Nerve Stimulation Practice: A Review of the Literature’, Pain Medicine (2016) 17(2): 325–336 (reporting percutaneous lead migration rates of 13–22%).
- Kumar K et al, ‘Spinal cord stimulation versus conventional medical management for neuropathic pain: a multicentre randomised controlled trial in patients with failed back surgery syndrome’, Pain (2007) 132(1–2): 179–188.
- Levy RM, ‘Device complication and failure management in neuromodulation’, Journal of Pain Research (2014) 7: 479–488.
- Rogers M et al, ‘Paddle versus percutaneous lead migration rates in spinal cord stimulation: a systematic review’, Neuromodulation (2020) 23(4): 462–469.
- Civil Liability Act 2002 (NSW); Civil Liability Act 2003 (Qld); Civil Liability Act 2002 (WA); Civil Liability Act 2002 (Tas); Wrongs Act 1958 (Vic); Civil Law (Wrongs) Act 2002 (ACT); Civil Liability Act 1936 (SA) — each establishing the standard of care and causation framework applicable to medical negligence claims in the relevant jurisdiction.
- Limitation Act 1969 (NSW); Limitation of Actions Act 1974 (Qld); Limitation Act 2005 (WA); Limitation Act 1974 (Tas); Limitation of Actions Act 1958 (Vic) — time limits for personal injury claims vary by jurisdiction and may be subject to extension in certain circumstances.
- Rogers v Whitaker (1992) 175 CLR 479 — High Court of Australia, establishing the standard for informed consent in Australian medical negligence law.
This article contains general legal information only. It does not constitute legal advice, and reading it does not create a lawyer–client relationship. The law applicable to medical negligence claims varies by state and territory in Australia. Each person’s circumstances differ. Time limits apply to legal claims in Australia and vary by jurisdiction. Seek independent legal advice about your specific situation.