Περίληψη:
Sixty patients were treated using a multilevel spinal instrumentation
system. Spine arthrodesis was done posteriorly in all patients using a
combination of two rods, hooks, screws, and cross-link plates. The
Galveston technique was used in three patients. Five patients presented
with late deep wound infections 1 to 5 years postoperatively. Two
patients presented with a local subcutaneous abscess, whereas the
remaining patients had a local drainage. Exploration revealed pus lining
the instrumentation surface, at least one loose cross-link nut, and
local hardware corrosion and metal infiltration of the surrounding
tissues. All patients had a satisfactory bony arthrodesis, so
instrumentation was removed. Intraoperative cultures revealed three
coagulase-negative Staphylococci, one Acinetobacter baumani, and one
Peptostreptococcus. A continuous irrigation system with antibiotics was
placed for 5 days in all patients in combination with intravenous
antibiotics and oral antibiotics. All patients responded to the
treatment, with no recurrence of the infection after removal of the
instrumentation. Although the exact nature of these infections requires
additional investigation, the findings suggest a correlation between
instrumentation failure and loosening and late infection. Bone
involvement was not observed and removal of instrumentation was a
reliable means of treatment.
Συγγραφείς:
Soultanis, K
Mantelos, G
Pagiatakis, A
Soucacos, PN
