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Review
. 2022 Dec;26(12):877-882.
doi: 10.1007/s11916-022-01090-2. Epub 2022 Dec 1.

A Comprehensive Review of Spinal Cord Stimulator Infections

Denis Cherkalin  1 , Sarang S Koushik  2 , Simran Dua  3 , Sadiq Rahman  1 , Timothy Edmonds  1 , Karina Gritsenko  1 , Naum Shaparin  1
Affiliations
Review

A Comprehensive Review of Spinal Cord Stimulator Infections

Denis Cherkalin et al. Curr Pain Headache Rep. 2022 Dec.

Abstract

Spinal cord stimulator (SCS) is approved to treat various pain conditions and is commonly seen in the chronic pain patient population. Due to the nature of the device and its location, infections associated with SCS have a particularly high morbidity. According to post-market data and medical device reports, 87% of patients receiving SCS implants were given perioperative antibiotics as the implantable neurostimulator or receiver pocket serve as the most common sites of infection. The most common antibiotics for surgical prophylaxis given are first-generation cephalosporins (cefalexin, cefazolin) at the time of implantation. If deep infection is suspected, imaging in the form of CT scan should be obtained as physical exam is not always sufficient. For infections involving the epidural space, vertebra, or intervertebral discs, MRI is the preferred imaging modality. If meningitis is suspected, a lumbar puncture is recommended. Positive cultures can help guide antibiotic therapy.

Keywords: Antibiotic therapy; Chronic pain; Infection; Neuromodulation; Spinal cord stimulation.

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References

    1. Sdrulla AD, Guan Y, Raja SN. Spinal cord stimulation: clinical efficacy and potential mechanisms. Pain Pract. 2018;18(8):1048–67. https://doi.org/10.1111/papr.12692 . - DOI
    1. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for Prevention of Surgical Site Infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee. Am J Infect Control. 1999;27: 97–132; quiz 133–134 discussion 96.
    1. Elsamadicy, Aladine A, et al. Drivers and risk factors of unplanned 30-day readmission following spinal cord stimulator implantation. Neuromodulation: Journal of the International Neuromodulation Society. 2018;21:87–92. https://doi.org/10.1111/ner.12689 .
    1. Follett KA, Boortz-Marx RL, Drake JM, et al. Prevention and management of intrathecal drug delivery and spinal cord stimulation system infections. Anesthesiology. 2004;100:1582–94. - DOI
    1. Hawn MT, Richman JS, Vick CC, et al. Timing of surgical antibiotic prophylaxis and the risk of surgical site infection. JAMA Surg. 2013;148(7):649–57. https://doi.org/10.1001/jamasurg.2013.134 . - DOI

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