title: Late infection of spinal instrumentation by hematogenous seeding.
abstract: Six cases of late spinal infection following instrumentation are described. In all cases, there was a delay of at least 10 months between surgery and the clinical development of sepsis. In 5 of the 6 cases, a distant focus of infection could be identified. Two patients had active intravenous drug usage, two patients were paraplegic with neurogenic bladders, and one patient had an episode of pyelonephritis secondary to renal calculi two months prior to presentation. In no instance was there any preceding breakdown of overlying skin. This previously unreported phenomenon is an extremely rare but major complication of spinal surgery.
authors: Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, Texas.
authors: M H
authors: MH
authors: Heggeness
authors: S I
authors: SI
authors: Esses
authors: T
authors: T
authors: Errico
authors: H A
authors: HA
authors: Yuan
mesh_terms: D000293:Adolescent; D000328:Adult; D001424:Bacterial Infections / Q000635:transmission*; D001769:Blood / Q000382:microbiology*; D016908:Gram-Positive Bacterial Infections / Q000635:transmission; D006801:Humans; D008297:Male; D009984:Orthopedic Fixation Devices; D011183:Postoperative Complications; D011425:Propionibacterium acnes; D013203:Staphylococcal Infections / Q000635:transmission; D013290:Streptococcal Infections / Q000635:transmission; D013530:Surgical Wound Infection / Q000209:etiology; D013997:Time Factors