Spinal Cord Stimulator Infection: Approach to Diagnosis, Management, and Prevention

Author:

Esquer Garrigos Zerelda1ORCID,Farid Saira2,Bendel Markus A3,Sohail M Rizwan1

Affiliation:

1. Division of Infectious Diseases, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA

2. Department of Medicine, Georgetown University–MedStar Washington Hospital Center, Washington, District of Columbia, USA

3. Department of Anesthesiology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA

Abstract

Abstract Spinal cord stimulation (SCS) is the most utilized invasive electrical neuromodulation treatment for the management of refractory chronic pain syndromes. Infection is one of the most dreaded complications related to SCS implantation and may prevent patients from receiving adequate pain treatment, adding to the initial cost and disability. Most SCS infections present as generator pocket infection. However, delay in diagnosis may lead to complications such as meningitis, epidural abscess, and/or vertebral osteomyelitis. Early recognition of SCS-related infections and associated complications is based on clinical suspicion, laboratory testing, and appropriate diagnostic imaging. While superficial surgical site infection following SCS implant may be treated with antibiotic therapy alone, deep infection involving implant warrants device removal to achieve cure. Duration of antimicrobial therapy depends on severity of clinical presentation and presence or absence of associated complications. Several preventive strategies can be incorporated in surgical practice to reduce the risk of SCS infection.

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Microbiology (medical)

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