Late postoperative infection following spinal instrumentation: stainless steel versus titanium implants.
Late postoperative infection following instrumented spinal surgery is a clinical entity that has emerged in recent years. The extended surface of the spinal instrumentation in combination with hematogenous seeding or intraoperative inoculation is the main predisposing factor. In order to investigate the contribution of the instrumentation material (stainless steel versus titanium implants) and mechanical loosening, two groups of patients are presented. The first group includes 50 idiopathic scoliotic patients who were treated with first-generation posterior stainless steel spinal segmental multihook instrumentation [Texas Scottish Rite Hospital (TSRH) instrumentation system], and the second group includes 45 similar patients who were treated with newer titanium implants (MOSS MIAMI, XIA, and CD). Follow-up ranged from 3 to 13 years. Six patients from the first group and one patient from the second group presented with late infections 1 to 7 years postoperatively. Common intraoperative findings were excessive inflammatory tissue and some degree of instrumentation loosening and corrosion (stainless steel). Removal of instrumentation in combination with appropriate antibiotics was an effective treatment. Further study with long-term follow-up is necessary in order to understand the exact incidence and pathology of such infections.
Department of Orthopaedic Surgery, University of Athens, School of Medicine, Athens, Greece. ksoultanis@otenet.gr
Konstantinos C
KC
Soultanis
Nikolaos
N
Pyrovolou
Konstantinos A
KA
Zahos
Georgios I
GI
Karaliotas
Anna
A
Lenti
Iasonas
I
Liveris
George C
GC
Babis
Panayotis N
PN
Soucacos
D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000453:epidemiology*; D012600:Scoliosis / Q000601:surgery*; D013193:Stainless Steel; D013997:Time Factors; D014025:Titanium
D013193:Stainless Steel; D014025:Titanium