Management of postoperative infections after spinal instrumentation

Allan D.O. Levi, Curtis A. Dickman, Volker K.H. Sonntag

Research output: Contribution to journalArticlepeer-review

218 Scopus citations

Abstract

The authors retrospectively reviewed 452 consecutively treated patients who underwent a spinal instrumentation procedure at a single institution to establish which patients and which surgical approaches might be associated with an increased risk of developing deep wound infections and to determine the efficacy with which the institution's current treatment strategy eradicates these infections. Wound infections occurred in 17 patients (10 men and seven women) with spinal instrumentation (incidence 3.8%). All infections occurred after posterior spinal instrumentation procedures (7.2%); there were no infections after anterior instrumentation procedures regardless of the level. Each patient was assigned an infection risk factor (RF) score depending on the number of RFs identified in an individual patient preoperatively. The mean RF score of patients who developed infections was 2.18, whereas the mean RF score for a procedure-matched, infection-free control group was 0,7 1. The mean number of days from surgery to clinical presentation was 7.6 days (range 4-120 days), and the mean increase in hospitalization time for the subset of patients who developed infections was 16.6 days. The most common organism isolated from wound cultures was Staphylococcus aureus (nine of 17 cases). Of the 17 patients, five had infections involving multiple organisms. All patients were infection free at a minimum of 8 months follow-up review. The current treatment regimen advocated at this institution consists of operative debridement of the infected wound, a course of intravenous followed by oral antibiotic medications, insertion of an antibiotic-containing irrigation-suction system for a mean of 5 days, and maintenance of the instrumentation system within the infected wound.

Original languageEnglish (US)
Pages (from-to)975-980
Number of pages6
JournalJournal of neurosurgery
Volume86
Issue number6
DOIs
StatePublished - Jun 1997

Keywords

  • deep wound infection
  • instrumentation
  • irrigation-suction system
  • postoperative infection
  • risk factor
  • spine

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

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