Intraoperative Findings of Pathologic Calcification Surrounding an Intrathecal Pain Pump: A Case Report

Pathologic calcification is a common complication of surgically implanted devices, increasing the incidence of subsequent infection. Most literature describing this phenomenon occurs with cardiac implanted devices. Documented reports of this complication, specifically in the setting of intrathecal pain pump (ITP) and spinal cord stimulator (SCS) implants, are minimal, with presumably low incidence.

We present a case of a 58-year-old healthy man with a history of motorcycle accident status post L4-S1 fusion complicated by post-laminectomy syndrome. In February 2023, the patient required replacement of his ITP pump and SCS as both were at the end of life. During the replacement procedure, milky fluid was present with extensive calcifications along the ITP pocket and surrounding the catheter, as well as a small amount around the SCS implantable pulse generator.

This case illustrates the potential effect on the administration of intrathecal medication and neuromodulation if pathologic calcification occurs.