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Abstract Objective . Spinal cord and peripheral neurostimulation techniques have been practiced since 1967 for the relief of pain, and some techniques are also used for improvement in organ function. Neuromodulation has recognized complications, although very rarely do these cause long-term morbidity. The aim of this article is to present a review of complications observed in patients treated with neurostimulation techniques. Methods . A review of the major recent publications in the literature on the subjects of spinal cord, occipital, sacral, and peripheral nerve field stimulation was conducted. Results . The incidence of complications reported varies from 30% to 40% of patients affected by one or more complications. Adverse events can be subdivided into hardware-related complications and biological complications. The commonest hardware-related complication is lead migration. Other lead related complications such as failure or fracture have also been reported. Common biological complications include infection and pain over the implant. Serious biological complications such as dural puncture headache and neurological damage are rarely observed. Conclusions . Spinal cord and peripheral neurostimulation techniques are safe and reversible therapies. Hardware-related complications are more commonly observed than biological complications. Serious adverse events such as neurological damage are rare.

Background Fish bone impaction in the pharynx is a common otolaryngological emergency. However, if the fish bone perforates the pharyngeal wall or the gastrointestinal wall and migrates to the neck tissues or organs, entering the lungs, mediastinum, heart, liver, biliary tract, spleen, pancreas, or other structures, or damages major blood vessels in the thoracic or abdominal cavities, it can lead to severe complications. This condition is rare and dangerous, potentially resulting in a series of serious complications, including neck abscess, thyroid abscess, thrombosis or air embolism of the cervical vessels, esophageal perforation, rupture of major mediastinal vessels, mediastinitis, aorto-esophageal fistula, lung abscess, spinal injury, sepsis, splenic abscess, hepatic abscess, anal fistula, and it may even be misdiagnosed as a tumor. Objective This narrative review synthesizes evidence on fish bone translocation complications to (1) identify high-risk clinical presentations, (2) guide site-specific imaging selection, and (3) inform multidisciplinary management strategies. Methods Use the keyword “fishbone” to systematically search articles from PubMed、CNKI and Embase databases from 1972 to 2024. Review all original articles and include them in this review where appropriate. This narrative review synthesizes evidence from case reports and observational studies to explore complications and management of fish bone translocation in uncommon sites. Given the predominance of heterogeneous case reports, a formal systematic review with meta-analysis was not feasible; however, we employed systematic search strategies to minimize selection bias. Conclusion To avoid severe complications, it is crucial to provide comprehensive information on the management of fish bone impaction. When fish bone removal cannot be achieved using laryngoscopy, prompt and decisive surgical intervention is required to extract the foreign body.

Background and objectivesDorsal root ganglion stimulation is an emerging therapy in the treatment of chronic pain. Compared with traditional spinal cord stimulation, it allows a discretely targeted stimulation profile and may act via differing mechanisms of action. Despite these advantages, little is known about the complications associated with this new modality.MethodsWe queried the MAUDE (Manufacturer and User Facility Device Experience) database for all entries named ‘Dorsal root ganglion stimulator for pain relief’ reported between May 1, 2016 and December 31, 2017. We verified these data through the Office of the Freedom of Information Act at the US Food and Drug Administration. We then eliminated duplicate entries and categorized each complication based on the event description. A secondary analysis was performed to characterize the serious adverse events and the severity of new neurologic symptoms and infections.ResultsWe identified 979 unique episodes following our process of deduplication. Almost half (47%) of entries were categorized as device-related complications, a quarter (28%) as procedural complications, with the remainder as patient complaints (12%), serious adverse events (2.4%), and ‘other’ complications (4.6%). The majority of complications were managed surgically with revision (n = 488; 49.8%) rather than explant (n = 161; 16.4%) events, respectively.ConclusionsThe ‘Dorsal root ganglion stimulator for pain relief’ device has been publicized as a breakthrough in neuromodulation technologies. As with any new technology, we must proceed with caution and re-evaluate effectiveness as information becomes available. The MAUDE database has provided safety data unique for this device that will aid in informed consent and further refinement of this innovative therapy.

Background Accidental ingestion of fish bone is a common cause of otolaryngological emergency. Migration of the ingested bone into the thyroid gland, however, occurs very rarely. The associated clinical presentation, symptoms and duration of discomfort are also highly variable between patients and can be diagnostically challenging. Case presentation Here, we report the case of a 71-year-old female patient presenting with an ingested fish bone that migrated into the right thyroid lobe as a rare cause of suppurative thyroiditis with the clinical features of sepsis. We outline the diagnostic approach, peri- and intraoperative management as well as complications. It is proposed that besides endoscopy, imaging methods such as ultrasound or computed tomography may be necessary to verify the diagnosis and location of an ingested fish bone. Prompt surgical removal of the foreign body and resection of the infectious focus is recommended to minimize the risk of local inflammation, recurrent nerve lesions and septic complications arising from the spread of infection. Conclusion Fish bone migration into the thyroid gland is an extremely rare event, the successful detection and surgical management of which can be achieved through a careful interdisciplinary approach.

Intrathoracic Migration of a Breast ImplantA 73-year-old woman with a history of breast-implant surgery and segmental lung resection had sudden displacement of her right breast implant during pulmonary-function testing.

This case report documents a rare instance of intraventricular migration of silicone oil (IVM-SiO), initially misinterpreted as intraventricular hemorrhage on computed tomography (CT), in a patient with a history of retinal detachment surgery. The report not only describes the unique presentation of this case but also synthesizes findings from previous case reports to summarize the diagnostic characteristics and classification of intracranial silicone oil migration. The patient, a 41-year-old male, presented with dizziness and a history of vitreoretinal surgeries, including silicone oil tamponade for retinal detachment. Initial CT scans revealed a high-density lesion in the left ventricular body, suggestive of hemorrhage. However, further diagnostic workup, including MRI and a detailed review of the patient's surgical and radiological history, led to the identification of IVM-SiO. This report discusses the radiological features and differential diagnosis of IVM-SiO, underlining the diagnostic challenges in distinguishing it from other intraventricular pathologies. The case highlights the importance of considering a history of vitreoretinal surgery in patients presenting with intraventricular lesions. It also presents a classification system for intracranial silicone oil based on its migration patterns and imaging characteristics, contributing to the growing body of literature on this rare but significant complication.

Silicone oil (SO) tamponade has been widely used in vitreoretinal surgery for complex retinal detachment cases, yet its migration into unintended intraocular spaces remains an uncommon but clinically significant complication. While sub-retinal and anterior chamber migration have been more frequently described, suprachoroidal SO migration is a rare event, with few reports in the literature. The underlying mechanisms proposed for this complication include transient hypotony, infusion cannula malposition, and structural vulnerabilities within the suprachoroidal space. This review synthesizes reported cases of suprachoroidal SO migration, detailing clinical presentations, surgical management approaches, and postoperative outcomes. Various drainage techniques have been attempted, including transscleral evacuation through posterior sclerotomies, internal drainage into the vitreous cavity via pars plana incisions, and adjunctive perfluorocarbon liquid injection to facilitate oil displacement. While some cases have been managed conservatively without surgical intervention, the long-term implications of retained SO in the suprachoroidal space remain largely unknown. Given its potential association with ciliary detachment, hypotony, and visual disturbances, careful patient monitoring is warranted. The current literature lacks comprehensive studies on the biological behavior of SO within the suprachoroidal compartment, and further investigations are necessary to assess its stability, potential toxic effects, and indications for surgical removal. This review aims to provide vitreoretinal surgeons with a systematic understanding of suprachoroidal SO migration, offering insights into pathophysiology, prevention strategies, and optimal surgical management based on current evidence.

Background The key to successful management of patients with metal-on-metal (MOM) THAs is to diagnose adverse local tissue reactions (ALTRs) early. ALTRs have been described in asymptomatic patients with resurfacing arthroplasties. Whether this concerning finding applies to modular MOM THAs is unknown. Questions/purposes We (1) determined the prevalence of ALTRs in asymptomatic patients with modular MOM THAs, (2) described any differences in the appearance of these lesions between symptomatic and asymptomatic patients, and (3) analyzed potential predictive factors for any associations with ALTR prevalence. Methods We evaluated 114 patients with modular MOM THAs who had MRI with metal artifact reduction sequence software and metal ion laboratory results at a mean of 57 months postoperatively. There were 83 asymptomatic and 31 symptomatic patients. We defined ALTRs as abnormal fluid collections, solid or semisolid pseudotumors, or muscle or bone damage. Ion levels, lesion size, and cup abduction angles were analyzed. Results Twenty-six (31%) asymptomatic patients had ALTR lesions, all of which were in the greater trochanteric area. Most lesions in symptomatic patients also were in that location, but there was more diversity of location in this group. The cup position among patients with ALTRs was generally good; the average abduction angle for the asymptomatic patients with ALTRs was 40°. In 24 (92%) and 22 (85%) of 26 asymptomatic patients with ALTRs, respectively, chromium and cobalt levels were below the 7-ppb threshold. Conclusions A 31% incidence of periarticular fluid collections in asymptomatic patients with modular MOM THAs is alarming and calls into question any algorithmic approach dependent on symptomatology. The presence of pain was insufficient to identify patients at risk for ALTRs. To determine whether routine cross-sectional imaging of all asymptomatic patients with MOM implants is necessary will require a larger study cohort, longer followup, and clearer understanding of the natural history of periarticular lesions in these patients. Level of Evidence Level III, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.