Cervical epidural abscess due to implantation of a spinal cord stimulation lead

Bara, Gregor; Thissen, Jost

doi:10.1002/ccr3.5931

Cited by 5 publications

(2 citation statements)

References 24 publications

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“…If an infection is suspected, practitioners should obtain appropriate cultures and perform imaging studies to confirm the diagnosis. Treatment typically involves the removal of infected hardware and antibiotic administration [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

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Spinal cord stimulator explant caused by post-incisional cellulitis secondary to Varicella Zoster Virus (shingles) infection: a case report

Mohabbati,

Papan

2023

J Med Case Reports

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Introduction Spinal Cord Stimulation (SCS) is a well-established therapy for refractory neuropathic pain, known for its safety and minimally-invasive nature. However, complications, including surgical site infections (SSIs), can arise post-implantation. SCS-related SSIs occur in 3.4% to 4.6% of cases within 90 days post-implant, often requiring device removal and impacting pain management and healthcare costs. The impulse generator, electrode implant site and lumbar/thoracic surgical site are commonly affected, with local skin flora and circulating organisms being the primary causes of infection. Case presentation An 80-year-old Lebanese male with chronic neuropathic lower back and bilateral leg pain, significantly impairing function, underwent prolonged hospitalizations for COVID-19 infection and acute-on-chronic pain with Urinary Tract Infection (UTI). Considering SCS as a therapeutic option, a successful trial led to permanent implantation, resulting in improved pain severity and functional capacity. However, three months later, the patient developed post-incisional cellulitis and wound dehiscence secondary to Varicella Zoster Virus (shingles) Infection directly over the Implantable Pulse Generator (IPG) incision line. Despite antibiotic treatment, the infection progressed, necessitating SCS system explantation. Discussion This represents the first reported case of VZV infection causing wound dehiscence and SCS explantation post-implantation. Contributing factors may include itching around the IPG site, facilitating deeper tissue inoculation. Laboratory and imaging tests may not reliably detect SSIs, and superficial infections may respond to antibiotics, while deep infections typically require implant removal. Early identification and intervention are vital to minimize complications. Conclusion This unique case emphasizes the need for heightened vigilance and monitoring in patients with viral infections near medical devices. A standardized approach to assessing and managing SCS-related infections is critical. Sharing such experiences contributes to improved understanding and treatment of these rare incidents.

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Section: Discussionmentioning

confidence: 99%

“…Regarding SCS-related infections, another study reported a rare cervical epidural abscess due to spinal cord stimulation lead implantation. The study highlighted that spinal epidural abscess is rare, with only two cases documented in the literature [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Spinal cord stimulator explant caused by post-incisional cellulitis secondary to Varicella Zoster Virus (shingles) infection: a case report

Mohabbati,

Papan

2023

J Med Case Reports

View full text Add to dashboard Cite

show abstract