Capsulectomy at Explant: Rethinking Spinal Cord Stimulator Infected Generator Pocket Management in the Immunocompromised-A Case Series.
Tigran Kesayan, Vida Motamedi, Jessica Hanflink et al.
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Case in brief
Two immunocompromised women with spinal cord stimulator (SCS) infections underwent explantation and capsulectomy. The first patient, with ulcerative colitis and psoriatic arthritis, developed granulation tissue and was found to have necrotic tissue and Staphylococcus schleiferi. The second patient, with postlaminectomy syndrome and rheumatoid arthritis, presented with wound dehiscence and was diagnosed with MRSA. Both patients recovered following targeted antibiotic therapy.
Diagnostic / clinical pearl
In immunocompromised patients with SCS infections, capsulectomy during explantation may enhance infection resolution by removing biofilm and necrotic tissue.
Why it matters
This case highlights the need to reconsider current guidelines regarding the management of infected SCS generator pockets, particularly in vulnerable populations.