Successful Reimplantation of Spinal Cord Stimulator One Year after Device Removal Due to Infection

Abstract

Spinal cord stimulation is an effective treatment modality for patients with numerous pain conditions. Although proven to be highly successful, device implantation does come with some inherent risks. One of the most challenging complications is perioperative infection. For most patients, a simple trial of oral antibiotics and in-office drainage of any superficial infectious material may be sufficient. Deeper infections with wound dehiscence necessitate device removal and intravenous antibiotic therapy. The question remains, if the device was previously providing pain relief for the patient, when is the appropriate time to reimplant the device after the infection has cleared? We describe the case of explantation of an infected device and successful reimplantation after 1 year.

Lumbar Spine Osteomyelitis After Permanent Spinal Cord Stimulator Implantation: A Case Report

“…Interestingly, a case report described a patient whose SCS was removed after notable surgical site dehiscence and required six weeks of intravenous antibiotics. The SCS was replanted one year after its removal, due to patient preference, with similar alleviation of her chronic pain symptoms [14]. Independent of patient preference, The Neurostimulation Appropriateness Consensus Committee recommends reimplantation can take place 90 days after the complete resolution of the infection [15].…”

Dehiscence and Deep Wound Infection After Spinal Cord Stimulator Implant Managed Without Explantation: A Case Report

“…10 The few that have been reported all involve some form of removal of the SCS device, either permanently or having it relocated. 7,[11][12][13] In a majority of the deep SSI cases, only parts of the SCS device needed to be removed (most commonly the IPG and extension leads) because the epidural portion is rarely affected by the infection. 3 In another retrospective analysis of SCS-associated infections performed by Bendel et al, 14 some patients were able to be treated with antibiotics only or with incision and drainage.…”

No more tears from surgical site infections in interventional pain management

“…The consensus for both the choice of appropriate SAP for the reimplantation of a spinal cord stimulator after device removal due to infection and the sufficient duration of reimplantation after control of the infection has not been established [ 22 , 23 ].…”