IMPLEMENTATION OF A HUB PROTOCOL FOR REDUCING COMPLICATIONS IN SPINAL CORD AND DORSAL ROOT GANGLION STIMULATION: REAL-WORLD EXPERIENCE FROM THE EASTERN SICILY PAIN MANAGEMENT HUB CENTER: S. Zappalà1, S. Stimolo2, M. Maria3, S. Brundo3, S. Caramma3 | 1Università di padova, Padova, Italy; 2Università di Padova, Italy; 3Policlinico G. Rodolico- San Marco, Catania, Italy

Introduction. Spinal cord stimulation (SCS) and dorsal root ganglion stimulation (DRGS) are cornerstones of neuromodulation for refractory chronic neuropathic pain. However, these procedures historically carry non-negligible infectious (3%–6%), neurological (2.31%), and mechanical complication rates that jeopardize efficacy and increase healthcare costs. This study evaluates the efficacy and safety of a standardized, multiphasic institutional protocol implemented at the Hub Center of Catania to minimize such adverse events in real-world practice.Methods. A retrospective observational study (January 2024–June 2025) evaluated 66 patients undergoing definitive SCS/DRGS implantation after a 30-day trial phase with >50% pain relief. The institutional protocol standardized three main phases: Pre-operative Phase Comprehensive clinical assessment, including psychological and functional evaluation for clinical eligibility , metabolic optimization (fasting glucose