Infection after spinal surgery and procedures.

Authors:
V Denaro
V Denaro
University Campus Bio-Medico of Rome
Italy

Eur Rev Med Pharmacol Sci 2019 Apr;23(2 Suppl):173-178

Department of Orthopaedics and Trauma Surgery, University Campus Bio-Medico of Rome, Rome, Italy.

Postoperative infections after spinal surgery are a challenging issue, difficult to diagnose and treat, that requires prolonged medical therapy and even surgery. In this paper, we aim to review the current standards in the diagnosis and treatment of post-procedural Spondylodiscitis (SD). We performed a review of the available literature focusing on diagnostic and therapeutic standards of post-procedural SD, both after minimally invasive procedures and open surgery. Spinal infections can occur in less invasive procedures with an incidence ranging from 0.26% to 2.75%. Post-surgical spinal infections range from 2.1% to 8.5% for instrumented surgery, whereas these are less than 1% in open surgery without instrumentation. MRI is currently the most sensitive and specific technique to diagnose postoperative SD. CT guided aspiration culture should be performed in all patients with deep-seated infections with negative blood cultures. Early infections start with wound healing problems within a few weeks from surgery, and the occurrence of fever and an increase in serum markers of inflammation. Late infections often cause chronic pain, implant failure, non-union or wound dehiscence even a long time after surgery. The onset of the infection differentiates the specific treatment. Indeed, in the early postoperative period spinal fusion is not appropriate yet, and the stability of the fusion site only relies on the instrumentation. Therefore, even when suitable, implant removal may lead to undesirable consequences. In chronic infections, on the other hand, implant removal is unlikely to determine instability since the fusion has already been accomplished.

Download full-text PDF

Source
http://dx.doi.org/10.26355/eurrev_201904_17487DOI Listing
April 2019
2 Reads

Publication Analysis

Top Keywords

invasive procedures
8
spinal infections
8
implant removal
8
open surgery
8
spinal surgery
8
surgery
8
infections
7
diagnose postoperative
4
technique diagnose
4
fusion appropriate
4
mri currently
4
currently sensitive
4
sensitive specific
4
specific technique
4
spinal fusion
4
performed patients
4
period spinal
4
patients deep-seated
4
culture performed
4
aspiration culture
4

Similar Publications