Diagnosis and management of hypersensitivity to titanium in implanted intrathecal pain pump: a case report.
Jack Kiernan, Cham Al Salak, Haig Tcheurekdjian et al.
✦ AI-curated · Sources linked
Case in brief
A patient with a history of lumbar spine surgery and refractory low back pain underwent two explants of an intrathecal pain pump due to suspected infection. However, the diagnosis revealed a type IV hypersensitivity to titanium, a component of the pump. The patient was successfully reimplanted with a new intrathecal drug delivery system encased in expanded polytetrafluoroethylene (ePTFE) fabric, preventing rejection.
What made this case unusual
The case highlights a rare hypersensitivity reaction to titanium in an implanted device, which is often mistaken for infection, leading to unnecessary explants.
Diagnostic / clinical pearl
Clinicians should consider hypersensitivity to device materials in patients with recurrent complications at the pump site, as it may mimic infection.
Why it matters
This case underscores the potential for successful reimplantation of neuromodulation devices using protective materials like ePTFE in patients with hypersensitivity reactions.