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Updated: Jun 13, 2026
In Vivo Mouse Model of Spinal Implant Infection
Published on: June 23, 2020
Infection after spinal fusion for pediatric spinal deformity: thirty years of experience at a single institution
Patrick J Cahill1, Drew E Warnick, Michael J Lee
1Shriners Hospitals for Children, Philadelphia, PA 19140, USA. pcahill@shrinenet.org
Insights
Infections after pediatric spinal deformity surgery are rare in idiopathic scoliosis but common in neuromuscular conditions. Implant removal due to infection can lead to significant deformity progression.
Area of Science:
- Orthopedic surgery
- Pediatric spinal deformity
- Infectious disease in surgery
Background:
- Previous reports have discussed infection rates after pediatric spinal deformity surgery.
- No prior studies have quantified deformity progression after such infections.
Purpose of the Study:
- Determine infection rates post-pediatric spinal deformity surgery.
- Assess the number of surgeries needed for infection treatment.
- Evaluate the necessity of implant removal and its effect on deformity.
- Identify the common microorganisms involved in postoperative infections.
Main Methods:
- Retrospective case study of 1571 pediatric patients.
- Minimum 2-year follow-up.
- Review of medical records and radiographs from 1975-2005.
Main Results:
- Infection rates varied by diagnosis: idiopathic scoliosis (0.5%), myelomeningocele (19.2%), myopathies (4.3%), cerebral palsy (11.2%).
- Average of 2 surgeries needed for infection eradication; ~50% required implant removal.
- 44% of infected patients showed significant deformity progression (avg. 27 degrees); implant removal increased progression risk.
- Common organisms: Staphylococcus aureus, S. epidermidis, Pseudomonas aeruginosa.
Conclusions:
- Postoperative infection is rare in idiopathic scoliosis but more common in neuromuscular conditions.
- Infection eradication is achievable, but implant removal is often necessary.
- Complete implant removal can result in substantial deformity progression.
Study Design:
A retrospective, consecutive case study of 1571 pediatric patients who underwent spinal deformity surgery and had minimum 2-year follow-up.
Objective:
To identify (1) the rate of infection after pediatric spinal deformity surgery; (2) the number of surgeries required to treat a postoperative infection after a pediatric spinal deformity surgery; (3) the percentage of patients with a postoperative infection after pediatric spinal deformity surgery who require implant removal to quantify the effect of removal on the deformity; and (4) the microbiology of postoperative infections after pediatric spinal deformity surgery.
Summary Of Background Data:
Several previous reports have discussed the rates of infection after spinal surgery for pediatric spinal deformity. No previous reports have quantified the rate and magnitude of deformity progression after infection in pediatric spinal deformity surgery.
Methods:
A retrospective review was performed of the medical records and radiographs of all children undergoing surgery for spinal deformity at the Shriners Hospital for Children in Chicago from January 1, 1975, to June 1, 2005.
Results:
The rate of infection varied based on underlying diagnosis: idiopathic scoliosis 0.5%, myelomeningocele 19.2%, myopathies 4.3%, and cerebral palsy 11.2%. On average, 2 surgeries were required to eradicate the infection. Approximately half of the patients required removal of the instrumentation to treat their infection. Forty-four percent of patients who developed an infection had significant progression of their deformity, with an average increase in deformity magnitude of 27 degrees. Implant removal predisposed patients to progression of deformity. The 3 most common organisms in order were Staphylococcus aureus, S. epidermidis, and Pseudomonas aeruginosa.
Conclusion:
Infection after spinal deformity in idiopathic scoliosis is rare but is relatively common in neuromuscular conditions. Eradication of infection can be expected, but implant removal is often required. Should implants be totally removed, significant progression of the deformity is possible.
