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When a pathogen enters the body and reproduces, it can cause an infection, damage body cells, and cause illness symptoms that eventually lead to disease. Therefore, its prevention requires breaking the chain of infection.
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Intraoperative Ultrasound in Spinal Surgery
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Infection after spinal surgery and procedures.

A Di Martino1, R Papalia, E Albo

  • 1Department of Orthopaedics and Trauma Surgery, University Campus Bio-Medico of Rome, Rome, Italy. r.papalia@unicampus.it.

European Review for Medical and Pharmacological Sciences
|April 13, 2019
PubMed
Summary
This summary is machine-generated.

Postoperative spinal infections, or Spondylodiscitis (SD), are challenging. Early diagnosis via MRI and prompt treatment based on infection timing are crucial for managing these difficult-to-treat spinal complications.

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Area of Science:

  • Orthopedic Surgery
  • Infectious Diseases
  • Neurosurgery

Background:

  • Postoperative spinal infections, specifically Spondylodiscitis (SD), present significant diagnostic and therapeutic challenges.
  • Incidence rates vary: 0.26%–2.75% for minimally invasive procedures, 2.1%–8.5% for instrumented surgery, and <1% for open surgery without instrumentation.
  • These infections necessitate prolonged treatment, often including further medical therapy or surgical intervention.

Purpose of the Study:

  • To review current diagnostic and therapeutic standards for post-procedural Spondylodiscitis (SD).
  • To consolidate knowledge on managing spinal infections following both minimally invasive and open surgical techniques.

Main Methods:

  • Comprehensive literature review focusing on diagnostic and therapeutic guidelines for post-procedural SD.
  • Analysis of diagnostic modalities, including Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) guided aspiration.
  • Evaluation of treatment strategies differentiating between early and late-onset infections.

Main Results:

  • MRI is identified as the most sensitive and specific imaging technique for diagnosing postoperative SD.
  • CT-guided aspiration culture is recommended for deep infections with negative blood cultures.
  • Early infections manifest with wound issues, fever, and elevated inflammatory markers; late infections present with chronic pain, implant failure, or dehiscence.

Conclusions:

  • The timing of spinal infection onset is critical in determining the appropriate treatment strategy.
  • Early-stage infections may require conservative management, as implant removal can compromise stability.
  • Late-stage infections, where fusion is typically achieved, may allow for safer implant removal if necessary.