Epidural Abscess During a Spinal Cord Stimulator Trial: A Case Report

Area of Science:

• Neurology
• Infectious Diseases
• Pain Management

Background:

• Spinal cord stimulation (SCS) is a treatment for low back and radicular pain.
• A trial period assesses SCS effectiveness and reduces permanent implant failure risk.
• Epidural abscess is a rare but serious complication, often presenting with non-specific symptoms.

Observation:

• A case of acute methicillin-sensitive Staphylococcus aureus epidural abscess occurred 72-96 hours into an SCS trial.
• The patient had no significant risk factors or prior immunocompromised state.
• The abscess developed despite strict aseptic technique and prophylactic antibiotics.

Findings:

• Epidural abscesses can arise rapidly during SCS trials.
• Early detection of spinal epidural abscesses is increasing, with more cases managed medically.
• Differentiating abscess pain from other back pain types can be challenging.

Implications:

• Clinicians must maintain a high index of suspicion for epidural abscess during SCS trials.
• Prompt diagnosis and management are crucial for favorable outcomes.
• This case highlights the importance of vigilance for rare complications in SCS therapy.