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Infection Rates of Electrical Leads Used for Percutaneous Neurostimulation of the Peripheral Nervous System
Brian M Ilfeld1, Rodney A Gabriel1, Michael F Saulino2,3
1Department of Anesthesiology, University of California San Diego, San Diego, CA, U.S.A.
Pain Practice : the Official Journal of World Institute of Pain
|September 28, 2016
Summary
Coiled percutaneous neurostimulation leads significantly reduce infection risk compared to noncoiled designs. This finding is crucial for improving patient safety during long-term peripheral nerve stimulation therapy.
Area of Science:
- Medical Devices
- Neurology
- Infectious Diseases
Background:
- Percutaneous neurostimulation delivers electrical current via leads for therapeutic goals like pain relief.
- Extended use of these leads (over a month) raises concerns about potential infections.
- A hypothesis proposed that coiled leads have a lower infection rate than noncoiled cylindrical leads.
Purpose of the Study:
- To compare the infection rates between coiled and noncoiled percutaneous neurostimulation leads.
- To evaluate the safety and efficacy of different lead designs in peripheral nerve stimulation.
Main Methods:
- A retrospective review of clinical studies on percutaneous neurostimulation of the peripheral nervous system was conducted.
- Studies included had a duration of over 2 days and reported adverse events.
- The primary endpoint was the number of infections per 1,000 indwelling days.
Main Results:
- Forty-three studies involving coiled and noncoiled leads were analyzed.
- Noncoiled leads showed a 25-fold greater risk of infection compared to coiled leads (P=0.006).
- Infection rates were 0.03 per 1,000 days for coiled leads versus 0.83 per 1,000 days for noncoiled leads.
Conclusions:
- Coiled percutaneous leads demonstrate a substantially lower risk of infection than noncoiled leads.
- This translates to approximately 1 infection per 30,000 indwelling days for coiled leads versus 1,200 for noncoiled leads.
- The coiled design is recommended for reducing infection complications in long-term neurostimulation therapy.
