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Instrumentation in patients with spinal infection
Max C Lee1, Michael Y Wang, Richard G Fessler
1Department of Neurosurgery, Stanford University Medical Center, Stanford, CA 94305, USA. maxclee@stanford.edu
Neurosurgical Focus
|January 8, 2005
Summary
Spinal instrumentation is effective for treating spinal infections. Radical debridement and titanium implants in pyogenic spinal infections led to successful fusion in most patients, demonstrating safety and efficacy.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Infectious Disease
Background:
- Spinal instrumentation in infected cases is controversial.
- Titanium implant effectiveness is based on limited retrospective data.
- Pyogenic spinal infections require effective treatment strategies.
Purpose of the Study:
- To demonstrate the effectiveness of spinal instrumentation in treating spinal infections.
- To review cases of spinal infection treated with instrumentation over 4 years.
- To search literature on instrumentation for pyogenic spinal infections.
Main Methods:
- Retrospective review of 30 patients with spinal infections treated with instrumentation.
- Diagnosis based on clinical, radiographic, and laboratory findings.
- Exclusion of medically managed cases and those without instrumentation.
Main Results:
- 29 of 30 patients achieved adequate spinal fusion.
- One death occurred 3 months post-surgery.
- Three patients developed deep wound infections; two experienced graft expulsion.
Conclusions:
- Radical debridement and spinal instrumentation are effective in managing spinal infections.
- The study demonstrates the efficacy of titanium implants in pyogenic spinal infections.
- Neurosurgical intervention aims to achieve culture, debridement, and stability.