title: Pseudarthrosis after postoperative wound infection in the lumbar spine.
abstract: This retrospective investigation attempts to define the incidence of fusion success after postoperative infection after a posterior lumbar fusion, as well as which risk factors may adversely affect arthrodesis after successful debridement. At an average follow-up of 37 months, 18 of 29 patients (62.1%) had a successful arthrodesis. Eighty-seven percent of patients whose fusion excluded the sacrum had a solid arthrodesis, compared with only 36% of those fusions including the sacrum. The fusion rate in female patients was 33.3%, compared with 82.4% in male patients. The rate of fusion with allograft bone was 17.2 versus 83.3% with autograft bone. Female sex, the use of allograft bone, and extension of the fusion mass to the sacrum significantly increase the incidence of nonunion after a postoperative deep spinal wound infection.
authors.affiliation: Department of Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
authors.forename: L E
authors.initials: LE
authors.lastname: Weiss
authors.forename: A R
authors.initials: AR
authors.lastname: Vaccaro
authors.forename: G
authors.initials: G
authors.lastname: Scuderi
authors.forename: M
authors.initials: M
authors.lastname: McGuire
authors.forename: S R
authors.initials: SR
authors.lastname: Garfin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000150:complications / Q000453:epidemiology; D016025:Bone Transplantation; D003646:Debridement; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D016268:Internal Fixators; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011542:Pseudarthrosis / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012447:Sacrum / Q000601:surgery*; D013122:Spinal Diseases / Q000601:surgery; D016103:Spinal Fractures / Q000601:surgery; D013123:Spinal Fusion / Q000009:adverse effects* / Q000295:instrumentation; D013530:Surgical Wound Infection / Q000150:complications* / Q000453:epidemiology; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D016896:Treatment Outcome