Management and Cost of Spinal Cord Stimulator Explants due to Infection

Area of Science:

• Neuromodulation
• Infectious Diseases
• Health Economics

Background:

• Spinal cord stimulation (SCS) device explants due to infection present significant clinical challenges and economic costs.
• Managing SCS device infections requires complex care pathways and substantial healthcare resources.

Purpose of the Study:

• To evaluate the financial implications of explanting spinal cord stimulation (SCS) devices due to infection.
• To analyze the costs associated with explant procedures and subsequent patient management following SCS device infection.

Main Methods:

• A retrospective analysis of eight years (2014-2022) of patient data from a UK neuromodulation center.
• Inclusion of data on explants, infection status, clinical records, and financial costs from hospital accounting and national databases.

Main Results:

• Of 215 explants, 23 were infection-related, primarily involving the implantable pulse generator.
• The median cost for explant and follow-up care was £16,957, rising to £26,172 when reimplantation was attempted.
• Reimplantation success was limited (35% overall), with a 30% reinfection rate in reimplanted patients.

Conclusions:

• Preventive strategies are essential to minimize SCS device infection risks and associated costs.
• Enhanced understanding of infection management can alleviate the clinical and economic burden of SCS infections.
• Reimplantation attempts require careful patient counseling due to high risks and limited success rates.