gms | German Medical Science

65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

11. - 14. Mai 2014, Dresden

Artikel

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Infection rates of percutaneously implanted leads for spinal cord stimulation after a trial phase: 4-year follow-up

Meeting Abstract

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  • Gregor A. Bara - Department of Functional Neurosurgery and Stereotaxy, Neurosurgical Clinic, Heinrich-Heine University Duesseldorf, Germany
  • Philipp J. Slotty - Department of Functional Neurosurgery and Stereotaxy, Neurosurgical Clinic, Heinrich-Heine University Duesseldorf, Germany
  • Jaroslaw Maciaczyk - Department of Functional Neurosurgery and Stereotaxy, Neurosurgical Clinic, Heinrich-Heine University Duesseldorf, Germany
  • Stefan Schu - Department of Functional Neurosurgery and Stereotaxy, Neurosurgical Clinic, Heinrich-Heine University Duesseldorf, Germany
  • Jan Vesper - Department of Functional Neurosurgery and Stereotaxy, Neurosurgical Clinic, Heinrich-Heine University Duesseldorf, Germany

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocP 107

doi: 10.3205/14dgnc503, urn:nbn:de:0183-14dgnc5036

Veröffentlicht: 13. Mai 2014

© 2014 Bara et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.

Gliederung

Text

Objective: Spinal Cord Stimulation is an established treatment for various chronic pain syndromes. In general the percutaneous lead is placed first and being externalized. Upon successful trial with an external pulse generator, the IPG is implanted. The externalized lead may be a potential pathway for germs and cause infections. Infection rates of up to 22% have been reported.

Method: Data was collected prospectively. The patients were implanted with paddle lead using an epiducer system for percutaneous implantation. All implantations were performed under local anesthesia. Prior to the final implantation of the implantable pulse generator, all patients underwent seven days of trial stimulation. 30 Minutes prior to surgery a single shot of Cefazolin has been given. The externalized lead was covered with a hydrocolloid dressing. During externalization and 5 days after IPG implantation patients were given Clindamycin 3 times daily. Median follow-up was 30 months.

Results: 312 patients have been implanted so far. Infections requiring removal of the SCS system occurred in 1.6% (n=5).

Conclusions: This study is the largest cohort of SCS patient studied for infections yet. With more indications emerging for SCS and more patients treated, sufficient data on infections becomes more important. Our rate of infection is lower than previously described in the literature. Strict asepsis, peri- and postoperative prophylactic antibiosis may reduce rate of infection efficiently.