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Postoperative Spine Infections.

Pawar AY, Biswas SK - Asian Spine J (2016)

Bottom Line: Spinal instrumentation also has an important role in the development of postoperative infections.This review analyses the risk factors that influence the development of postoperative infection.Preventive measures to avoid surgical site (SS) infection in spine surgery and methods for reduction of all the changeable risk factors are discussed in brief.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, D.Y. Patil Medical College, Pune, India.; Department of Orthopedics, Ruby Hall Clinic, Pune, India.

ABSTRACT
Postoperative spinal wound infection increases the morbidity of the patient and the cost of healthcare. Despite the development of prophylactic antibiotics and advances in surgical technique and postoperative care, wound infection continues to compromise patient outcome after spinal surgery. Spinal instrumentation also has an important role in the development of postoperative infections. This review analyses the risk factors that influence the development of postoperative infection. Classification and diagnosis of postoperative spinal infection is also discussed to facilitate the choice of treatment on the basis of infection severity. Preventive measures to avoid surgical site (SS) infection in spine surgery and methods for reduction of all the changeable risk factors are discussed in brief. Management protocols to manage SS infections in spine surgery are also reviewed.

No MeSH data available.


Related in: MedlinePlus

(A–D) Computed tomography scan in the same patient showing lucency around spinal hardware.
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Figure 2: (A–D) Computed tomography scan in the same patient showing lucency around spinal hardware.

Mentions: Plain radiographs of the spine are rarely useful for the diagnosis of early infection [8916]. In the setting of discitis, there may be evidence of loss of disc height and end plate erosion. In latent infections, lucencies may be present around orthopedic hardware. Magnetic resonance imaging (MRI) is the most useful study to diagnose SSI [1891016]. Gadolinium enhancement improves the diagnostic accuracy of MRI and should be used whenever infection is suspected. Findings must be interpreted based on the timing since the index procedure and other potentially confounding conditions since tissue edema from noninfectious causes may mimic the appearance of infection. Rim enhancing fluid collections, ascending epidural collections, evidence of bony destruction, and progressive marrow signal changes are all suggestive of infection (Fig. 1). If infection is suspected in patients with hardware in the spine, computed tomography scan done at an early stage can detect lucency around orthopedic implants (Fig. 2).


Postoperative Spine Infections.

Pawar AY, Biswas SK - Asian Spine J (2016)

(A–D) Computed tomography scan in the same patient showing lucency around spinal hardware.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4764532&req=5

Figure 2: (A–D) Computed tomography scan in the same patient showing lucency around spinal hardware.
Mentions: Plain radiographs of the spine are rarely useful for the diagnosis of early infection [8916]. In the setting of discitis, there may be evidence of loss of disc height and end plate erosion. In latent infections, lucencies may be present around orthopedic hardware. Magnetic resonance imaging (MRI) is the most useful study to diagnose SSI [1891016]. Gadolinium enhancement improves the diagnostic accuracy of MRI and should be used whenever infection is suspected. Findings must be interpreted based on the timing since the index procedure and other potentially confounding conditions since tissue edema from noninfectious causes may mimic the appearance of infection. Rim enhancing fluid collections, ascending epidural collections, evidence of bony destruction, and progressive marrow signal changes are all suggestive of infection (Fig. 1). If infection is suspected in patients with hardware in the spine, computed tomography scan done at an early stage can detect lucency around orthopedic implants (Fig. 2).

Bottom Line: Spinal instrumentation also has an important role in the development of postoperative infections.This review analyses the risk factors that influence the development of postoperative infection.Preventive measures to avoid surgical site (SS) infection in spine surgery and methods for reduction of all the changeable risk factors are discussed in brief.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, D.Y. Patil Medical College, Pune, India.; Department of Orthopedics, Ruby Hall Clinic, Pune, India.

ABSTRACT
Postoperative spinal wound infection increases the morbidity of the patient and the cost of healthcare. Despite the development of prophylactic antibiotics and advances in surgical technique and postoperative care, wound infection continues to compromise patient outcome after spinal surgery. Spinal instrumentation also has an important role in the development of postoperative infections. This review analyses the risk factors that influence the development of postoperative infection. Classification and diagnosis of postoperative spinal infection is also discussed to facilitate the choice of treatment on the basis of infection severity. Preventive measures to avoid surgical site (SS) infection in spine surgery and methods for reduction of all the changeable risk factors are discussed in brief. Management protocols to manage SS infections in spine surgery are also reviewed.

No MeSH data available.


Related in: MedlinePlus