Management of delayed infection after internal fixation of thoracic-lumbar spine with pedicle screw via posterior approach
- VernacularTitle:胸腰椎脊柱后路椎弓根螺钉系统内固定术后迟发性感染处理
- Author:
Zheng WANG
;
Yan WANG
;
Zhengsheng LIU
- Publication Type:Journal Article
- Keywords:
spine;
internal fixators;
orthopedic procedures;
delayed infection
- From:
Medical Journal of Chinese People's Liberation Army
1981;0(06):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the diagnosis and treatment of delayed infection after pedicle screw internal fixation via posterior approach. Methods The management of 17 cases of delayed infection after posterior pedicle screw internal fixation was retrospectively analyzed. Imaging examination was done before operation in all the patients. In petients whose operation was done within 9 months and non-fusion of bone graft was proved, debridement and suction-irrigation were given. For the patients in whom bone graft had fused, the implant was removed, followed by debridement, irrigation, and wound closure. Specimens were taken during operation for bacteriological study. Intravenous antibiotic was given after operation in all the patients. When 3 successive bacterial culture of wound drainage were proved to be negative and total drainage fluid was less than 50ml in 24h, drainage tube was removed. Results Wounds healed in all the patients. In 8 of 12 cases wound healed after debridement and irrigation-suction. In 9 patients fusion of the bone graft was confirmed, and internal fixators were removed, followed by debridement, irrigation-suction and primary closure of the incisions. In 4 cases infection recurred 3-18 months after first stage debridement and irrigation-suction, but X-ray confirmed that there was fusion of the bone graft. In 11 of 17 cases bacterial cultures were positive. Conclusions Delayed infection is a severe complication after internal fixation of the spine. Debridement and irrigation-suction are effective in controlling infection, and at the same time, it allows fusion of the bone graft. Removal of the internal fixators is not indispensable.
