Treatments for Spine Infection After Surgery Assessed

Combo of posterior surgery, anterior debridement with fusion after antibiotics effective

WEDNESDAY, Jan. 26 (HealthDay News) -- Anterior spine infection may occur following posterior pedicle screw instrumentation but can be successfully treated with combined posterior surgery and anterior debridement with fusion, according to a study published in the January issue of The Spine Journal.

Ming-Kai Hsieh, M.D., from the Chang Gung Memorial Hospital in Taiwan, and colleagues analyzed data from 11 patients with postoperative anterior spondylodiscitis, which developed after posterior pedicle screw instrumentation. Patients were treated with antibiotics and then underwent combined posterior surgery and anterior debridement with fusion, concurrently or in staged operations.

The researchers note that postoperative anterior infection was diagnosed between two and 36 months following the initial posterior surgery. All patients were treated with parenteral antibiotics for four to six weeks, and then with oral antibiotics for a total of three months, based on the culture report. Eradication of the infection was determined by the levels of C-reactive protein and the erythrocyte sedimentation rate. The patients responded positively to antibiotic treatment and had complete eradication of infection. A favorable clinical outcome of Grade I or Grade II fusion was successfully achieved in all patients.

"We have proposed the removal of spinal implants and debridement when the patients had a concomitant posterior infection," the authors write. "According to our treatment protocol, the spinal infection was completely eradicated in all patients."

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