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Chronic infections of the spine

Teresa Bas1, Paloma Bas, Alejandro Blasco

  • 1Unidad de Raquis, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario y Politécnico La FE, Valencia, Spain. teresabas@gmail.com

European Journal of Orthopaedic Surgery & Traumatology : Orthopedie Traumatologie
|June 8, 2013
PubMed

Insights

Chronic infections after posterior spinal fusion are rare but serious. Eradicating these infections requires removing pathogens, biofilm, and affected tissues, often necessitating prolonged antibiotic treatment and potentially repeat surgeries.

Area of Science:

  • Spine surgery
  • Infectious diseases
  • Orthopedics

Background:

  • Chronic infections post-posterior fusion are uncommon.
  • These infections can occur long after initial surgery.
  • They stem from direct inoculation or hematogenous spread.

Purpose of the Study:

  • To outline the challenges and management strategies for chronic infections following posterior spinal fusion.
  • To detail the necessary components for eradicating these deep-seated infections.
  • To discuss treatment protocols including surgical intervention and antibiotic therapy.

Main Methods:

  • Surgical debridement to remove pathogens, biofilm, non-viable tissues, and instrumentation.
  • Administration of appropriate antibiotic therapy (short or long protocols).
  • Consideration of repeat surgeries to manage complications like deformity or pseudoarthrosis.

Main Results:

  • Successful eradication depends on thorough removal of infectious material and instrumentation.
  • Antimicrobial therapy protocols vary in duration (4-9 weeks).
  • Some cases require re-operation to preserve spinal stability and alignment.

Conclusions:

  • Management of chronic post-fusion infections is complex, requiring a multi-faceted approach.
  • Surgical intervention combined with targeted antibiotherapy is crucial for successful outcomes.
  • Careful consideration of repeat surgery is vital to prevent long-term complications.

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