Objective: To discuss a case of female patient with musculoskeletal complications related to damage to her sacral neuromodulation device which occurred as a result of a slip and fall.
Clinical Features: 46-year-old female patient with low back pain after slip and fall. The physical exam of this patient involved palpation and orthopedic exams, including Laslett's criteria for identifying sacroiliac joint pain. Segmental overpressure, with prone hip extension, demonstrated right sacroiliac joint restriction along with left sacroiliac joint pain.
Intervention and Outcomes: Treatment consisted of spinal manipulation, using Thompson drop technique, on the left sacroiliac joint. The patient reported only transient improvement. A careful review of the chief complaint was conducted. The patient reported that she had a sacral neural stimulator implanted in her left gluteal tissue, for the management of urinary incontinence. The patient was asked to 34
turn off her device, via remote control, and her pain was instantly relieved. Urology explanted the device to the opposite gluteal region, with no complications.
Conclusion: This case illustrates the importance of reviewing past medical history and ROS for visceral/surgical causes for MSK pain. This appears to be the first case in the literature of adverse event due to accidental damage to a sacral neurostimulator medical device.
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