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Updated: Jul 5, 2026
04:42
Treating Low Back Pain in Failed Back Surgery Patients with Multicolumn-lead Spinal Cord Stimulation
Published on: June 26, 2018
Epidural abscess due to spinal cord stimulator trial
Jacob J Rauchwerger1, Gregg H Zoarski, Romanth Waghmarae
1Department of Anesthesiology/Division of Pain Management, University of Maryland Medical Center, Baltimore, Maryland, USA. jacobjeffrey74@hotmail.com
Summary
Early methicillin-resistant Staphylococcus aureus (MRSA) infection is a risk after spinal cord stimulator implantation. Prompt device removal is crucial to manage deep infections like epidural abscesses.
Area of Science:
- Neurosurgery
- Infectious Disease
- Medical Device Technology
Background:
- Spinal cord stimulation (SCS) is a common treatment for chronic low back pain and lumbar radiculopathy, especially in failed back surgery syndrome.
- Infection is a known complication of implanted electronic devices, with Staphylococcus aureus being a frequent pathogen.
Observation:
- A case of rapid, early-onset methicillin-resistant Staphylococcus aureus (MRSA) infection following a brief SCS trial lead implantation is presented.
- The infection manifested with subtle symptoms, highlighting the challenge in early diagnosis of deep-seated infections.
Findings:
- Deep infections, such as epidural abscesses, necessitate high clinical suspicion, even with minimal signs and symptoms.
- The presence of a foreign body (implanted device) significantly impairs the body's ability to clear infection, mandating immediate explantation.
- Methicillin-resistant Staphylococcus aureus (MRSA), including community-associated strains, is an increasingly prevalent cause of these infections.
Implications:
- Healthcare providers must maintain vigilance for deep infections post-SCS lead implantation.
- Prompt diagnosis and immediate removal of the infected device are critical for successful treatment.
- Further surgical intervention may still be required even after device explantation to manage complications like epidural abscesses.
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