Meningitis

Parkinson's disease

Refractory (planetary science)

Spinal cord stimulator

Surgery

Spinal cord stimulation

Abscess

Psychiatry

Osteomyelitis

Physics

Spinal cord

Epidural abscess

Implant

Central nervous system

Neuromodulation

Internal medicine

Astrobiology

Medicine

Vertebral osteomyelitis

Disease

Deep brain stimulation

Clinical Infectious Diseases

Spinal cord stimulation (SCS) is the most utilized invasive electrical neuromodulation treatment for the management of refractory chronic pain syndromes. Infection is one of the most dreaded complications related to SCS implantation and may prevent patients from receiving adequate pain treatment, adding to the initial cost and disability. Most SCS infections present as generator pocket infection. However, delay in diagnosis may lead to complications such as meningitis, epidural abscess, and/or vertebral osteomyelitis. Early recognition of SCS-related infections and associated complications is based on clinical suspicion, laboratory testing, and appropriate diagnostic imaging. While superficial surgical site infection following SCS implant may be treated with antibiotic therapy alone, deep infection involving implant warrants device removal to achieve cure. Duration of antimicrobial therapy depends on severity of clinical presentation and presence or absence of associated complications. Several preventive strategies can be incorporated in surgical practice to reduce the risk of SCS infection.

Spinal Cord Stimulator Infection: Approach to Diagnosis, Management, and Prevention