P051: SUCCESSFUL RE-IMPLANTATION OF SPINAL CORD STIMULATOR ONE YEAR AFTER DEVICE REMOVAL DUE TO INFECTION
Ruben Schwartz, DO1; Warren Southerland, MD2; Ivan Urits, MD2; Alan Kaye, MD3; Omar Viswanath, MD4; 1Mount Sinai Medical Center of Florida; 2Beth Israel Deaconness Medical Center; 3Louisiana State University Health Science Center; 4Valley Anesthesiology and Pain Consultants
Spinal cord stimulation (SCS) is an effective treatment modality for patients with chronic pain. SCS has demonstrated clinical benefit in patients with complex regional pain syndrome, failed back surgery syndrome, critical limb ischemia, and refractory angina pectoris. SCS therapy comes with the risk of potential complications including device failure, lead migration, loss of therapeutic paresthesia, and infection. For most clinicians, the management of these complications involves removal of the device and immediate re-implantation, except in the case of an infection. Although only seen in approximately 2.45% of SCS implants, infected devices are some of the most dreaded complications and add the risk of meningitis, epidural abscess, and vertebral osteomyelitis. It is crucial for physicians to recognize potential infections in a timely manner to prevent these more serious adverse effects. After explantation and initiation of antibiotic coverage, the question remains; what is the appropriate time to wait to re-implant? We briefly describe the case of the removal of an infected SCS device and successful re-implantation after a year.