Late Infection of Spinal Instrumentation.
- Author:
Jae Ik SHIM
1
;
Taik Seon KIM
;
Sung Jong LEE
;
Suk Ha LEE
;
Dong Ki LEE
;
Yoen Sik YU
;
Yun Yeup KIM
Author Information
1. Department of Orthopaedic Surgery, Korea Veterans Hospital, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Spine;
Late infection;
Instrumentation and fusion
- MeSH:
Anti-Bacterial Agents;
Back Pain;
Blood Sedimentation;
C-Reactive Protein;
Debridement;
Diagnosis;
Follow-Up Studies;
Humans;
Retrospective Studies;
Risk Factors;
Spine;
Staphylococcus
- From:Journal of Korean Society of Spine Surgery
2000;7(1):29-36
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
STUDY DESIGN: A retrospective analysis of five cases of late spinal infection after spinal instrumentation and fusion. OBJECTIVES: These cases are reviewed to verify risk factors for late spinal infection after elective instrumentation and to manifest the treatment of this complication. SUMMARY OF LITERATURE REVIEW: Late spinal infection after elective spinal instrumentation and fusion are uncommon. The diagnosis is usually hard and requires much clinical suspicion. MATERIALS AND METHODS: 5 cases were in total 374 patients of the author's cases. These cases are reviewed retrospectively. RESULTS: All patients reported aggravated back pain. 4 patients had elevated erythrocyte sedimentation rates, averaging 44.8 mm/hour and elevated C-reactive protein, averaging 26.2mg/L. No distance foci of infection was identified. All patients got the radiolucent zone around screw fixation site, averaging 4.6mmwidth. The organisms were S. epidermidis in 1 case and coagulase(-) staphylococcus in 1 case. All cases were treated by operative method with debridement, instrument removal with or without revision and postoperative intravenous antibiotics. The average follow-up period was 18.2 months, one patient recurred back pain at 7 months after operation. CONCLUSION: The diagnosis of late infection after elective spinal instrumentation and fusion requires high suspicion of clinical symptoms and signs. All except one were successfully treated by operative treatment.
