BACKGROUND: Generator pocket pain (GPP) may develop in spinal cord stimulation (SCS) patients, with a frequency ranging from 0.9% to 64%. While several treatments have been proposed, the only available options for SCS patients experiencing refractory pain are implantable pulse generator (IPG) relocation or removal.

CASE REPORT: We treated a 62-year-old man with late-onset refractory GPP using the autologous microfragmented adipose tissue (MFAT) injection into the IPG pocket. A total of 30 mL of MFAT harvested from abdominal fat was injected. The procedure was well tolerated, with no adverse events. The patient reported a significant reduction in pain intensity immediately after the injection, with his visual analog scale (VAS) score decreasing from 80 to 20/100. At the third-month follow-up, he continued to experience the same level of pain relief.

CONCLUSION: The autologous MFAT injection in refractory GPP patients is a promising salvage option. However, additional cases will be needed to better evaluate the efficacy and long-term outcomes of this treatment.

KEYWORDS: Generator pocket pain, microfragmented adipose tissue, spinal cord stimulation (SCS)