Postoperative deep surgical-site infection after instrumented spinal surgery: a multicenter study.
A retrospective survey revealed 37 cases (1.1%) of deep surgical-site infection (SSI) among 3,462 instrumented spinal surgeries between 2004 and 2008. Excluding 8 patients who were unclassifiable, we categorized 29 patients into 3 groups of similar backgrounds-thoracolumbar degenerative disease (the DEG group; n = 15), osteoporotic vertebral collapse (the OVC group; n = 10), and cervical disorders (the cervical group; n = 4)-and investigated the key to implant salvage. Final respective implant retention rates for the groups were 40, 0, and 100%, with the OVC group having the worst rate (p < 0.01). In the DEG group with early infection, those whose implants were retained had lower body temperatures, lower white blood cell counts, and a lower rate of discharge at the time of SSI diagnosis (p < 0.05). Implant retention may be affected by initial spinal pathology. In the DEG group, debridement before drainage may be advantageous to implant salvage.
Department of Orthopaedic Surgery, Hoshigaoka Koseinenkin Hospital, Hirakata, Osaka, Japan.
Masayoshi
M
Ishii
Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Motoki
M
Iwasaki
Department of Orthopaedic Surgery, Kansai Rosai Hospital, Hyogo, Japan.
Tetsuo
T
Ohwada
Department of Orthopaedic Surgery, Osaka Rosai Hospital, Osaka, Japan.
Takenori
T
Oda
Department of Orthopaedic Surgery, Himeji Red Cross Hospital, Hyogo, Japan.
Takashi
T
Matsuoka
Department of Orthopaedic Surgery, Toyonaka Municipal Hospital, Osaka, Japan.
Yuichi
Y
Tamura
Department of Orthopaedic Surgery, Toneyama Hospital, Osaka, Japan.
Kazutaka
K
Izawa
spinal instrumentation; spinal surgery; surgical-site infection; treatment