Spinal Cord Stimulator Related Infections: Findings From a Multicenter Retrospective Analysis of 2737 Implants

Area of Science:

• Neurosurgery
• Infectious Disease
• Medical Device Technology

Background:

• Surgical site infection (SSI) is a known complication of spinal cord stimulator (SCS) implantation.
• Current management guidelines for SCS-related infections are based on limited, often outdated, clinical studies.
• There is a need for large-scale, contemporary data on SCS infection epidemiology, diagnosis, and treatment.

Purpose of the Study:

• To conduct a large-scale retrospective analysis of spinal cord stimulator (SCS) implantation procedures.
• To investigate the incidence, causative organisms, and management strategies for SCS-related infections.
• To provide updated insights into the diagnosis and treatment of SCS infections.

Main Methods:

• A multicenter retrospective study involving 2737 SCS implant procedures across 11 institutions in the United States.
• Analysis of all identified infections and associated complications over a seven-year period.
• Review of diagnostic methods, causative pathogens, infection sites, and treatment outcomes, including explantation and salvage therapies.

Main Results:

• An overall infection rate of 2.45% was observed among the 2737 SCS implant procedures.
• The most frequent presenting signs were localized incisional pain and wound erythema.
• Staphylococcus aureus was the most common pathogen, and the implantable pulse generator (IPG) pocket was the most frequent infection site. Explantation was performed in 77.6% of infected cases.

Conclusions:

• This study offers current epidemiological data on spinal cord stimulator (SCS) related infections.
• Findings highlight common clinical presentations, pathogens, and infection locations.
• The results provide valuable insights into current diagnostic and treatment approaches for SCS infections, including the success of salvage therapies.