Prognosis of deep infection in spinal surgery using implants, treated by retention, removal of bone graft and lengthy antibiotherapy

Caceres, Aileen; Jiménez, J.S. Lucena; Martín-Gallego, Álvaro; Duran, Joan; Diaz, B. Sobrino; Puerta, D. García de Quevedo

doi:10.1016/j.recote.2018.10.004

Cited by 2 publications

(2 citation statements)

References 15 publications

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“…Of these, only 49 articles were found relevant, and were used for the synthesis below. 8 – 56 Below is the summary of their findings. Relevancy was determined purely based on if the articles answered any one of the following: (1) implant removal rate, (2) common bacterial organisms found following infection, (3) time of onset, and (4) ratio of superficial to deep infection.…”

Section: Resultsmentioning

confidence: 99%

“…16 A few studies had close to 0% to 10% implant removal. [17][18][19][20] Yin et al 21,22 in their 2010-2014 series were able to retain implant in 40 of 41 cases of late onset SSI. In contrast, many other studies required implant removal on all or majority of cases, for example, 13 of 13, 26 of 26, 20 of 20, 10 of 10 (100%), and so on.…”

Section: Implant Removal/retention Ratementioning

confidence: 99%

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Implant Retention or Removal for Management of Surgical Site Infection After Spinal Surgery

Agarwal

Kelkar

Agarwal

et al. 2019

Global Spine Journal

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Study Design: A literature review.Objective: To summarize the implant removal rate, common bacterial organisms found, time of onset, ratio of superficial to deep infection, and regurgitating the prevalence among all the retrospective and prospective studies on management and characterization of surgical site infections (SSIs). Methods:PubMed was searched for articles published between 2000 and 2018 on the management or characterization of SSIs after spinal surgery. Only prospective and retrospective studies were included. Results: A total of 49 articles were found relevant to the objective. These studies highlighted the importance of implant removal to avoid recurrence of SSI. The common organisms detected were methicillin-resistant Staphylococcus aureus, methicillin-resistant Staphylococcus epidermis, Staphylococcus epidermis, Staphylococcus aureus, and Propionibacterium acnes, with prevalence of 1% to 15%. A major proportion of all were deep SSI, with minority reporting on late-onset SSI. Conclusion: Long-term antibiotics administration, and continuous irrigation and debridement were common suggestion among the authors; however, the key measure undertaken or implied by most authors to avoid risk of recurrence was removal or replacement of implants for late-onset SSI.

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Section: Resultsmentioning

confidence: 99%

Section: Implant Removal/retention Ratementioning

confidence: 99%

Implant Retention or Removal for Management of Surgical Site Infection After Spinal Surgery

Agarwal

Kelkar

Agarwal

et al. 2019

Global Spine Journal

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Surgical Site Infection Management following Spinal Instrumentation Surgery: Implant Removal vs. Implant Retention: an Updated Systematical Review

Yudistira¹,

Putera²,

Imran³

et al. 2022

Acta Inform Med

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Background: The number of lumbar spine surgery increased in recent years. Spinal instrumentation surgery was an integral component in the treatment of spinal pathologies, which can cause surgical site infection (SSI). Surgical site infections (SSIs) are the leading cause of mortality and morbidity after spinal instrumentation surgery. The management of SSI was implant retention and removal is still unclear. Objective: The objective of this literature is to systematically review the implant removal and retention method for SSI management after spinal instrumentation surgery. Methods: We searched in PubMed and ScienceDirect for cohort and randomized control trial studies in English, published between 2002 and 2022, which had data on patients with spinal instrumentation surgery. The underlying disease, comorbidities, common bacteria, type of infection, the onset of infection, implant removal, and retention percentage and recommendation were analyzed. Bias analysis using Newcastle-Ottawa Quality Assessment. Results: We included 15 studies with a total sample were 2.584 with an average of age 15 to 66 years old. The most common organism detected were S. Aureus, MRSA, and S. Epidermis. The most common surgical procedure indications were degenerative followed by scoliosis. Implant removal and retention rate were 0-100% and 0-90,32% respectively. Implant removal is more frequently used in patients after spinal instrumentation surgery than the implant retention method. Conclusion: Implant retention can be performed in case of SSI is < 3 months after surgery. Implant removal is recommended if the incidence of SSI is > 3 months. Empirical antibiotics therapy is necessary to reduce the possibility of implant removal after debridement. Further studies on the effect of implant removal and retention in patients on infection recurrence, pain, and quality of life of patients are needed.

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Prognosis of deep infection in spinal surgery using implants, treated by retention, removal of bone graft and lengthy antibiotherapy

Cited by 2 publications

References 15 publications

Implant Retention or Removal for Management of Surgical Site Infection After Spinal Surgery

Implant Retention or Removal for Management of Surgical Site Infection After Spinal Surgery

Surgical Site Infection Management following Spinal Instrumentation Surgery: Implant Removal vs. Implant Retention: an Updated Systematical Review

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