title: Chronic infection of a Brindley sacral nerve root stimulator.
abstract: The Finetech-Brindley sacral anterior root stimulator (SARS) is implanted for the treatment of bladder dysfunction following spinal cord injury (SCI) and has been successful in improving micturition in many patients with SCI. This case describes a 62-year-old man who presented with a chronic Staphylococcus aureus infection of a Brindley SARS 26 years after implantation following a T5 American Spinal Injury Association A spinal cord injury (T5 ASIA A SCI). He presented with chronic sacral osteomyelitis with a history of periodic implant erosion through the skin. Following a series of interventions, definitive management involved removal of the intradural electrodes and epidural and intradural phlegmon, ligation of the thecal sac and flap reconstruction. In the case of delayed infection of a Brindley SARS, removal of the entire system should be considered, especially if extension of the infection to the intradural compartment is suspected.
authors.affiliation: Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Alexa
authors.initials: A
authors.lastname: Bramall
authors.affiliation: Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Bednash
authors.initials: B
authors.lastname: Chaudhary
authors.affiliation: Department of Surgery, The Plastic Surgery Clinic, Toronto, Ontario, Canada.
authors.forename: Jamil
authors.initials: J
authors.lastname: Ahmad
authors.affiliation: Department of Surgery, University of Toronto, Toronto, Ontario, Canada Department of Surgery, Toronto Western Hospital, Toronto, Ontario, Canada.
authors.forename: Mohammed F
authors.identifier: http://orcid.org/0000-0003-4510-2855
authors.initials: MF
authors.lastname: Shamji
mesh_terms: D004567:Electrodes, Implanted / Q000009:adverse effects* / Q000382:microbiology; D006801:Humans; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D013119:Spinal Cord Injuries / Q000382:microbiology*; D013126:Spinal Nerve Roots; D013211:Staphylococcus aureus / Q000302:isolation & purification; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000209:etiology / Q000382:microbiology* / Q000628:therapy; D014554:Urination