Infections in spinal instrumentation

Int Orthop. 2012 Feb;36(2):457-64. doi: 10.1007/s00264-011-1426-0. Epub 2012 Jan 5.

Abstract

Surgical-site infection (SSI) in the spine is a serious postoperative complication. Factors such as posterior surgical approach, arthrodesis, use of spinal instrumentation, age, obesity, diabetes, tobacco use, operating-room environment and estimated blood loss are well established in the literature to affect the risk of infection. Infection after spine surgery with instrumentation is becoming a common pathology. The reported infection rates range from 0.7% to 11.9%, depending on the diagnosis and complexity of the procedure. Besides operative factors, patient characteristics could also account for increased infection rates. These infections after instrumented spinal fusion are particularly difficult to manage due to the implanted, and possibly infected, instrumentation. Because the medical, economic and social costs of SSI after spinal instrumentation are enormous, any significant reduction in risks will pay dividends. The goal of this literature review was to analyse risk factors, causative organisms, diagnostic elements (both clinical and biological), different treatment options and their efficiency and consequences and the means of SSI prevention.

Publication types

  • Review

MeSH terms

  • Antibiotic Prophylaxis
  • Debridement
  • Humans
  • Prosthesis-Related Infections / diagnosis
  • Prosthesis-Related Infections / epidemiology*
  • Prosthesis-Related Infections / prevention & control*
  • Prosthesis-Related Infections / therapy
  • Reoperation
  • Risk Factors
  • Spinal Diseases / surgery
  • Spinal Fusion / instrumentation*
  • Surgical Wound Infection / diagnosis
  • Surgical Wound Infection / epidemiology*
  • Surgical Wound Infection / prevention & control*
  • Surgical Wound Infection / therapy
  • Therapeutic Irrigation / methods