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Infection of a Retained Peripheral Nerve Stimulation Lead: A Case Report
John J Finneran1, Bryan T Leek2, Brian M Ilfeld1
1From the Departments of Anesthesiology.
Abstract:
Percutaneous peripheral nerve stimulation is used to provide analgesia for weeks or even months. While infection of any percutaneously implanted object is a concern, it is exceedingly rare for helically coiled leads, with a reported incidence of less than 1 infection for every 32,000 indwelling days. We now report an infected helically coiled lead requiring sedation for extraction and complicated by lead fracture during removal, leaving a remnant in situ. The infection was successfully treated with oral antibiotics. We speculate on the cause of this infection and propose steps to prevent this complication, including the avoidance of sling-to-lead insertion site overlap.
Insights
Infection of percutaneous peripheral nerve stimulation leads is rare. This case highlights a rare infection and lead fracture during removal, emphasizing prevention strategies.
Area of Science:
- Pain Management
- Neuromodulation
- Medical Device Technology
Background:
- Percutaneous peripheral nerve stimulation (PNS) offers prolonged analgesia.
- Helically coiled leads have an exceptionally low infection rate, under 1 per 32,000 days.
Observation:
- A rare case of infection involving a helically coiled PNS lead is reported.
- Lead extraction required sedation and was complicated by intraoperative fracture, leaving a remnant.
Findings:
- The infection was successfully managed with oral antibiotics.
- Lead fracture during removal is a potential complication.
Implications:
- This case underscores the importance of vigilance for rare complications in PNS.
- Preventive measures, such as avoiding sling-to-lead insertion site overlap, are proposed.
