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Related Experiment Videos

Postoperative posterior spinal wound infections.

J B Massie1, J G Heller, J J Abitbol

  • 1Department of Orthopaedic Surgery, University of California, San Diego.

Clinical Orthopaedics and Related Research
|November 1, 1992
PubMed
Summary

Spinal surgery infections are more common with complex procedures and instrumentation. Early diagnosis, surgical cleaning, and antibiotics are key to effective treatment, often allowing instrumentation to remain in place.

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Area of Science:

  • Orthopedics
  • Infectious Disease
  • Surgical Outcomes

Background:

  • Postoperative spinal infections are a significant complication, with incidence rising alongside surgical complexity.
  • Procedures like diskectomy carry a low infection risk (<1%), while spinal fusion, especially with instrumentation, presents a higher risk (1-6%+).

Purpose of the Study:

  • To review postoperative posterior spinal infections over a three-year period.
  • To identify common causative organisms, risk factors, and effective treatment strategies for spinal infections.

Main Methods:

  • Retrospective review of 22 cases of postoperative posterior spinal infections.
  • Analysis of patient demographics, surgical procedures, identified organisms, and treatment outcomes.

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Main Results:

  • Staphylococcus aureus was the most frequent pathogen (>50%).
  • Risk factors included advanced age, obesity, diabetes, immunosuppression, prolonged surgery (>5 hours), and instrumentation.
  • Effective treatment involved early diagnosis, surgical debridement, irrigation, and six weeks of parenteral antibiotics.

Conclusions:

  • Spinal surgery complexity and instrumentation are associated with increased infection risk.
  • Prompt and comprehensive treatment, including surgical intervention and antibiotics, is crucial for managing spinal infections.
  • Instrumentation can often be preserved during treatment of postoperative spinal infections.