Postmortem Protocols of Implantable Neurosurgical Devices: A Cross-Sectional Survey

Abstract

BackgroundImplantable devices are increasingly more common for management of movement disorders, pain, and epilepsy. These devices are often complex and constructed of non-biodegradable or hazardous materials. Therefore, proper post-mortem handling of these devices is exceedingly important. Unfortunately, there is no consolidated resource available for post-mortem neuromodulation device protocols. Thus, we surveyed and catalogued the protocols for implantable devices to summarize proper post-mortem device protocols for implantable neurosurgical devices currently on the market. MethodsWe performed a cross-sectional study of companies producing commonly implanted neurosurgical devices. Using information from company websites, user manuals, and catalogs we categorized devices into three groups: A (formal recommendation for explantation), B (recommendation for explantation without formal company protocol), and C (explantation is not necessary). We then compiled the data into a stoplight diagram, providing a clear post-mortem disposal algorithm for each device category. ResultsTwelve companies were queried regarding 46 devices. Post-mortem protocols were available for 50% (23/46) of devices; the remaining devices did not have formal recommendations. Overall, 50% of devices were classified as Category A "red light" on the stoplight diagram based on recommendations, 10.9% as Category B "yellow light," and the remaining 39.1% were classified as Category C "green light" indicating they are safe to bury or cremate. ConclusionsEvolution in therapies and growth in functional neurosurgery has expanded the range of implantable neurosurgical devices. We provide an educational document summarizing their post-mortem protocols. This resource aims to aid healthcare providers and encourage proper disposal practices during burial or cremation.