Use of an Antibacterial Envelope in Spinal Cord Stimulation Reduces the Rate and Severity of Iatrogenic Infections

Mathias Kirk Simoni Kristensen*, Jeppe Toft Filtenborg, Rares Miscov, Helga Angela Gulisano, Carsten Reidies Bjarkam

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review


OBJECTIVE: To examine if the use of an antibacterial envelope (TYRX) decreases the rate of postoperative infection in chronic pain patients undergoing treatment with spinal cord stimulation (SCS) involving device implantation.

METHODS: Single-center retrospective cohort study comparing postoperative infections rates in non-TYRX recipients from 2018 to 2020 with recipients of a TYRX antibacterial envelope from 2020 to 2021. Infection was registered if a patient received any form of antibiotic treatment after hospital discharge within a follow-up period of 100 days.

RESULTS: A total of 198 patients were included: 100 in the TYRX group and 98 in the non-TYRX group. There were no significant differences between the 2 groups regarding age, body mass index (BMI), smoking, diabetes, and use of immunosuppression. The overall infection rate was 5.6%. The infection rate was 4% in the TYRX group and 7.1% in the non-TYRX group (P = 0.6). However, the 4 cases of postoperative infection in the TYRX group could be effectively managed with oral antibiotics alone, whereas 6 out of the 7 patients in the non-TYRX group required intravenous antibiotics. Moreover, device explantation was necessary in 3 of these patients suggesting the event of more severe infections in the non-TYRX group (P = 0.014).

CONCLUSIONS: The TYRX antibacterial envelope displayed infection rates reducing capabilities, along with a clear tendency to reduce revision surgeries and system removals due to infections.

Original languageEnglish
JournalWorld Neurosurgery
Pages (from-to)e820-e826
Number of pages7
Publication statusPublished - May 2024

Bibliographical note

Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.


  • Antibacterial envelope
  • Complications
  • Implantable pulse generator
  • Infection
  • Neuromodulation
  • Prophylaxis
  • Spinal cord stimulation


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