Intrathecal catheter for severe low back pain during deep brain stimulation placement: illustrative case

BACKGROUND: Deep brain stimulation (DBS) is a U.S. Food and Drug Administration–approved therapy for medically refractory Parkinson’s disease, essential tremor, and other neurological conditions. The procedure requires prolonged immobility and can result in significant patient discomfort, potentially limiting patient selection. In addition, surgical requirements necessitate avoidance of medications that may alter or suppress the patient’s arousal or baseline tremor during macrostimulation testing. OBSERVATIONS: In this study, the authors describe the use of continuous spinal anesthesia with local anesthetic to manage a patient with severe back pain who was intolerant of semisupine position during stereotactic computed tomography and stage 1 of DBS placement. LESSONS: Continuous spinal anesthesia is an effective strategy to manage patients with severe back pain undergoing DBS surgery for upper extremity motor symptoms.