Management of infection after instrumented posterior spine fusion in pediatric scoliosis.

Management of infection after instrumented posterior spine fusion in pediatric scoliosis. Research Abstract Details 

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Management of infection after instrumented posterior spine fusion in pediatric scoliosis. Abstract Text:

Christine Ho,David L Skaggs,Jennifer M Weiss,Vernon T Tolo,Christine Ho,David L Skaggs,Jennifer M Weiss,Vernon T Tolo,

STUDY DESIGN: Case series retrospective review. OBJECTIVE: To identify what factors predict successful eradication of infection after I&D of an infected posterior spinal fusion with instrumentation. SUMMARY OF BACKGROUND DATA: The treatment of infection of instrumented spine fusions in children has few clear guidelines in the literature. METHODS: The medical records of patients who required a surgical irrigation and debridement (I&D) for infection after posterior spinal fusion and instrumentation for scoliosis from 1995 to 2002 were retrospectively reviewed. RESULTS: Fifty-three patients were identified with the following underlying diagnoses: 21 patients (40%) idiopathic scoliosis, 10 patients (23%) cerebral palsy, 3 patients (6%) spina bifida, 1 patient (2%) congenital scoliosis, and 17 patients (32%) other. There were 31 patients (58%) with surgery <6 months from initial fusion, and 22 (42%) patients >6 months. Of the 43 patients with implant retained at the time of the first I&D, 20 patients required a second I&D (47%). Of the 10 patients with complete implant removal, 2 patients required a second I&D (20%). Coagulase-negative Staphylococcus was the most prevalent organism, growing in 25 (47%) of the cultures. Of patients with idiopathic scoliosis, 8 of 21 (38%) required a second I & D; of the patients with other diagnoses, 14 of 32 (44%) required a second I&D, which was not a significant difference (P > 0.05). CONCLUSION: To the best of our knowledge, this is the largest reported series of spinal implant infections. When children with an infection after posterior spinal fusion with instrumentation undergo irrigation and debridement, there is a nearly 50% chance that the infection will remain if all spinal implants are not removed. As nearly 50% of the infections were caused by coagulase-negative Staphylococcus, we recommend that prophylactic antibiotic coverage for this organism is used at the time of the initial spinal fusion.

Management of infection after instrumented posterior spine fusion in pediatric scoliosis. Publishing Authors By Initials

C Ho,DL Skaggs,JM Weiss,VT Tolo,C Ho,DL Skaggs,JM Weiss,VT Tolo,

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Management of infection after instrumented posterior spine fusion in pediatric scoliosis. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Spine

VOLUME: 32

Page Numbers: 2739-44

Journal Abbreviation: Spine

ISSN: 1528-1159

DAY: 15

MONTH: Nov

YEAR: 2007

Management of infection after instrumented posterior spine fusion in pediatric scoliosis. Information

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LANGUAGE: eng

NlmUniqueID: 7610646

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AFFILIATION: Department of Orthopaedics, Texas Scottish Rite Hospital for Children, Dallas, TX, USA.

Country: United States

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MEDLINETA: Spine

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