Infection rate of spinal cord stimulators after a screening trial period. A 53-month third party follow-up.

OBJECTIVES

Spinal cord stimulator (SCS) infections are common (2.5-13%) and may cause harm. It is unclear if a screening trial with definitive leads presents an increased infection risk.

METHODS

Eighty-four patients with SCS implantations were reviewed from 2004 to May 2008 with a trial period lasting 1-3 weeks.

RESULTS

During the trial one infection (1.2%) occurred with removal of the SCS leads. Three infections (3.6%) occurred after the second stage and were successfully treated with antibiotics. No full implant was explanted due to infection. The more skilled/experienced operator had a lower infection rate (1.8%) than the less skilled/experienced (13%).

CONCLUSIONS

Our infection rate (4.8%) compared favorably with our previous survey (7.5%). The reduced number of SCS infections is likely to be due to: strict asepsis, double layer hydrocolloid dressing during the trial, prophylactic antibiotics, operator experience, and patient education. Two-stage procedures with extended trials do not seem to increase the incidence of SCS infections.