Implantable Direct Current Spinal Fusion Stimulators Do Not Decrease Implant-Related Infections in a Rabbit Model
Ebrahim Paryavi, MD, MPH, Moshe Yanko, MD, David Jaffe, MD, Naren Nimmagadda, MD, Jenna Noveau, MD, Jason Schiavone, BA, Mohit Gilotra, MD, Daniel Gelb, MD, and Steven C. Ludwig, MD
Electrical current detaches bacterial biofilm from implanted instrumentation. Hypothetically, this can decrease implant-related infection and allow retention of instrumentation in cases of postoperative wound infections.
We conducted a prospective animal study to investigate whether a 60-μAmp implantable direct current (DC) fusion stimulator decreases implant-related infection rates in a multilevel fixed-implant postoperative spinal wound infection model in rabbits. Three dorsal sites, T13, L3, and L6, were instrumented in each rabbit. A 60-μAmp DC fusion stimulator was implanted in a subcutaneous pouch lateral to the instrumented sites, and leads were connected to 2 of 3 sites in each rabbit. All sites were inoculated with methicillin-sensitive Staphylococcus aureus (MSSA). Rabbits were euthanized at 7 days, and cultures were obtained from the surgical sites, including wound swab, bone, and implants.
No significant reduction was observed in postoperative infection rates of bone or implant with 60-μAmp DC (95% and 77%, respectively) compared with no current
(91% and 82%, respectively) (P > .5). No significant difference was observed in bacterial load (Ps = .25-.72) between sites receiving DC and control sites.
Currently used 60-μAmp DC implantable spinal fusion stimulators do not significantly reduce the rate of postoperative implant-related spinal wound infections in a rabbit model.