Implant-Associated Infection of Long-Segment Spinal Instrumentation: A Retrospective Analysis of 46 Consecutive Patients

Study Design This single-center retrospective study analyzed patients with an implant-associated infection of spinal instrumentation (four or more segments) treated between 2010 and 2018. Purpose This study aimed to investigate the treatment of implant-associated infections of long-segment spinal instrumentation and to define risk factors for implant removal. Overview of Literature Implant-associated infection occurs in 0.7%–20% of spinal instrumentation. Significant blood loss, delayed reoperation, and use of effective antibiotics are reported risk factors for implant removal. Methods Patients with superficial infections not involving the implant were excluded. All patients received surgical and antibiotic treatments according to our interdisciplinary osteomyelitis board protocol. An infection was considered healed if a patient showed no signs of infection 1 year after termination of treatment. The patients were divided into an implant retention group and implant removal group, and their clinical and microbiological data were compared. Results Forty-six patients (27 women, 19 men) with an implant-associated infection of long-segment spinal instrumentation and mean age of 65.3±14.3 years (range, 22–89 years) were included. The mean length of the infected instrumentation was 6.5±2.4 segments (range, 4–13 segments). Implant retention was possible in 21 patients (45.7%); in the other 25 patients (54.3%), a part of or the entire implant required removal. Late infections were associated with implant removal, which correlated with longer hospitalization. Both groups showed high postoperative complication rates (50%) and high mortality rates (8.7%). In 39 patients (84.8%), infection was eradicated at a mean follow-up of 18.9±11.1 months (range, 12–60 months). Three patients (6.5%) were lost to follow-up. Conclusions Implant-associated infections of long-segment spinal instrumentations are associated with high complication and mortality rates. Late infections are associated with implant removal. Treatment should be interdisciplinary including orthopedic surgeons and clinical infectiologists. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Stavros Oikonomidis [verfasserIn] Lisa Altenrath [verfasserIn] Leonard Westermann [verfasserIn] Jan Bredow [verfasserIn] Peer Eysel [verfasserIn] Max Joseph Scheyerer [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2021

Schlagwörter:	spinal infection implant-associated infection long-segmental spinal instrumentation deep surgical site infection

Übergeordnetes Werk:	In: Asian Spine Journal - Korean Spine Society, 2018, 15(2021), 2, Seite 234-243
Übergeordnetes Werk:	volume:15 ; year:2021 ; number:2 ; pages:234-243

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc Journal toc

DOI / URN:	10.31616/asj.2019.0391

Katalog-ID:	DOAJ05207076X

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allfields	10.31616/asj.2019.0391 doi (DE-627)DOAJ05207076X (DE-599)DOAJ01bd0b25815948d88a9b0863fb006a39 DE-627 ger DE-627 rakwb eng Stavros Oikonomidis verfasserin aut Implant-Associated Infection of Long-Segment Spinal Instrumentation: A Retrospective Analysis of 46 Consecutive Patients 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Study Design This single-center retrospective study analyzed patients with an implant-associated infection of spinal instrumentation (four or more segments) treated between 2010 and 2018. Purpose This study aimed to investigate the treatment of implant-associated infections of long-segment spinal instrumentation and to define risk factors for implant removal. Overview of Literature Implant-associated infection occurs in 0.7%–20% of spinal instrumentation. Significant blood loss, delayed reoperation, and use of effective antibiotics are reported risk factors for implant removal. Methods Patients with superficial infections not involving the implant were excluded. All patients received surgical and antibiotic treatments according to our interdisciplinary osteomyelitis board protocol. An infection was considered healed if a patient showed no signs of infection 1 year after termination of treatment. The patients were divided into an implant retention group and implant removal group, and their clinical and microbiological data were compared. Results Forty-six patients (27 women, 19 men) with an implant-associated infection of long-segment spinal instrumentation and mean age of 65.3±14.3 years (range, 22–89 years) were included. The mean length of the infected instrumentation was 6.5±2.4 segments (range, 4–13 segments). Implant retention was possible in 21 patients (45.7%); in the other 25 patients (54.3%), a part of or the entire implant required removal. Late infections were associated with implant removal, which correlated with longer hospitalization. Both groups showed high postoperative complication rates (50%) and high mortality rates (8.7%). In 39 patients (84.8%), infection was eradicated at a mean follow-up of 18.9±11.1 months (range, 12–60 months). Three patients (6.5%) were lost to follow-up. Conclusions Implant-associated infections of long-segment spinal instrumentations are associated with high complication and mortality rates. Late infections are associated with implant removal. Treatment should be interdisciplinary including orthopedic surgeons and clinical infectiologists. spinal infection implant-associated infection long-segmental spinal instrumentation deep surgical site infection Medicine R Lisa Altenrath verfasserin aut Leonard Westermann verfasserin aut Jan Bredow verfasserin aut Peer Eysel verfasserin aut Max Joseph Scheyerer verfasserin aut In Asian Spine Journal Korean Spine Society, 2018 15(2021), 2, Seite 234-243 (DE-627)60349207X (DE-600)2502303-2 19767846 nnns volume:15 year:2021 number:2 pages:234-243 https://doi.org/10.31616/asj.2019.0391 kostenfrei https://doaj.org/article/01bd0b25815948d88a9b0863fb006a39 kostenfrei http://www.asianspinejournal.org/upload/pdf/asj-2019-0391.pdf kostenfrei https://doaj.org/toc/1976-1902 Journal toc kostenfrei https://doaj.org/toc/1976-7846 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2021 2 234-243
spelling	10.31616/asj.2019.0391 doi (DE-627)DOAJ05207076X (DE-599)DOAJ01bd0b25815948d88a9b0863fb006a39 DE-627 ger DE-627 rakwb eng Stavros Oikonomidis verfasserin aut Implant-Associated Infection of Long-Segment Spinal Instrumentation: A Retrospective Analysis of 46 Consecutive Patients 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Study Design This single-center retrospective study analyzed patients with an implant-associated infection of spinal instrumentation (four or more segments) treated between 2010 and 2018. Purpose This study aimed to investigate the treatment of implant-associated infections of long-segment spinal instrumentation and to define risk factors for implant removal. Overview of Literature Implant-associated infection occurs in 0.7%–20% of spinal instrumentation. Significant blood loss, delayed reoperation, and use of effective antibiotics are reported risk factors for implant removal. Methods Patients with superficial infections not involving the implant were excluded. All patients received surgical and antibiotic treatments according to our interdisciplinary osteomyelitis board protocol. An infection was considered healed if a patient showed no signs of infection 1 year after termination of treatment. The patients were divided into an implant retention group and implant removal group, and their clinical and microbiological data were compared. Results Forty-six patients (27 women, 19 men) with an implant-associated infection of long-segment spinal instrumentation and mean age of 65.3±14.3 years (range, 22–89 years) were included. The mean length of the infected instrumentation was 6.5±2.4 segments (range, 4–13 segments). Implant retention was possible in 21 patients (45.7%); in the other 25 patients (54.3%), a part of or the entire implant required removal. Late infections were associated with implant removal, which correlated with longer hospitalization. Both groups showed high postoperative complication rates (50%) and high mortality rates (8.7%). In 39 patients (84.8%), infection was eradicated at a mean follow-up of 18.9±11.1 months (range, 12–60 months). Three patients (6.5%) were lost to follow-up. Conclusions Implant-associated infections of long-segment spinal instrumentations are associated with high complication and mortality rates. Late infections are associated with implant removal. Treatment should be interdisciplinary including orthopedic surgeons and clinical infectiologists. spinal infection implant-associated infection long-segmental spinal instrumentation deep surgical site infection Medicine R Lisa Altenrath verfasserin aut Leonard Westermann verfasserin aut Jan Bredow verfasserin aut Peer Eysel verfasserin aut Max Joseph Scheyerer verfasserin aut In Asian Spine Journal Korean Spine Society, 2018 15(2021), 2, Seite 234-243 (DE-627)60349207X (DE-600)2502303-2 19767846 nnns volume:15 year:2021 number:2 pages:234-243 https://doi.org/10.31616/asj.2019.0391 kostenfrei https://doaj.org/article/01bd0b25815948d88a9b0863fb006a39 kostenfrei http://www.asianspinejournal.org/upload/pdf/asj-2019-0391.pdf kostenfrei https://doaj.org/toc/1976-1902 Journal toc kostenfrei https://doaj.org/toc/1976-7846 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2021 2 234-243
allfields_unstemmed	10.31616/asj.2019.0391 doi (DE-627)DOAJ05207076X (DE-599)DOAJ01bd0b25815948d88a9b0863fb006a39 DE-627 ger DE-627 rakwb eng Stavros Oikonomidis verfasserin aut Implant-Associated Infection of Long-Segment Spinal Instrumentation: A Retrospective Analysis of 46 Consecutive Patients 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Study Design This single-center retrospective study analyzed patients with an implant-associated infection of spinal instrumentation (four or more segments) treated between 2010 and 2018. Purpose This study aimed to investigate the treatment of implant-associated infections of long-segment spinal instrumentation and to define risk factors for implant removal. Overview of Literature Implant-associated infection occurs in 0.7%–20% of spinal instrumentation. Significant blood loss, delayed reoperation, and use of effective antibiotics are reported risk factors for implant removal. Methods Patients with superficial infections not involving the implant were excluded. All patients received surgical and antibiotic treatments according to our interdisciplinary osteomyelitis board protocol. An infection was considered healed if a patient showed no signs of infection 1 year after termination of treatment. The patients were divided into an implant retention group and implant removal group, and their clinical and microbiological data were compared. Results Forty-six patients (27 women, 19 men) with an implant-associated infection of long-segment spinal instrumentation and mean age of 65.3±14.3 years (range, 22–89 years) were included. The mean length of the infected instrumentation was 6.5±2.4 segments (range, 4–13 segments). Implant retention was possible in 21 patients (45.7%); in the other 25 patients (54.3%), a part of or the entire implant required removal. Late infections were associated with implant removal, which correlated with longer hospitalization. Both groups showed high postoperative complication rates (50%) and high mortality rates (8.7%). In 39 patients (84.8%), infection was eradicated at a mean follow-up of 18.9±11.1 months (range, 12–60 months). Three patients (6.5%) were lost to follow-up. Conclusions Implant-associated infections of long-segment spinal instrumentations are associated with high complication and mortality rates. Late infections are associated with implant removal. Treatment should be interdisciplinary including orthopedic surgeons and clinical infectiologists. spinal infection implant-associated infection long-segmental spinal instrumentation deep surgical site infection Medicine R Lisa Altenrath verfasserin aut Leonard Westermann verfasserin aut Jan Bredow verfasserin aut Peer Eysel verfasserin aut Max Joseph Scheyerer verfasserin aut In Asian Spine Journal Korean Spine Society, 2018 15(2021), 2, Seite 234-243 (DE-627)60349207X (DE-600)2502303-2 19767846 nnns volume:15 year:2021 number:2 pages:234-243 https://doi.org/10.31616/asj.2019.0391 kostenfrei https://doaj.org/article/01bd0b25815948d88a9b0863fb006a39 kostenfrei http://www.asianspinejournal.org/upload/pdf/asj-2019-0391.pdf kostenfrei https://doaj.org/toc/1976-1902 Journal toc kostenfrei https://doaj.org/toc/1976-7846 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2021 2 234-243
allfieldsGer	10.31616/asj.2019.0391 doi (DE-627)DOAJ05207076X (DE-599)DOAJ01bd0b25815948d88a9b0863fb006a39 DE-627 ger DE-627 rakwb eng Stavros Oikonomidis verfasserin aut Implant-Associated Infection of Long-Segment Spinal Instrumentation: A Retrospective Analysis of 46 Consecutive Patients 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Study Design This single-center retrospective study analyzed patients with an implant-associated infection of spinal instrumentation (four or more segments) treated between 2010 and 2018. Purpose This study aimed to investigate the treatment of implant-associated infections of long-segment spinal instrumentation and to define risk factors for implant removal. Overview of Literature Implant-associated infection occurs in 0.7%–20% of spinal instrumentation. Significant blood loss, delayed reoperation, and use of effective antibiotics are reported risk factors for implant removal. Methods Patients with superficial infections not involving the implant were excluded. All patients received surgical and antibiotic treatments according to our interdisciplinary osteomyelitis board protocol. An infection was considered healed if a patient showed no signs of infection 1 year after termination of treatment. The patients were divided into an implant retention group and implant removal group, and their clinical and microbiological data were compared. Results Forty-six patients (27 women, 19 men) with an implant-associated infection of long-segment spinal instrumentation and mean age of 65.3±14.3 years (range, 22–89 years) were included. The mean length of the infected instrumentation was 6.5±2.4 segments (range, 4–13 segments). Implant retention was possible in 21 patients (45.7%); in the other 25 patients (54.3%), a part of or the entire implant required removal. Late infections were associated with implant removal, which correlated with longer hospitalization. Both groups showed high postoperative complication rates (50%) and high mortality rates (8.7%). In 39 patients (84.8%), infection was eradicated at a mean follow-up of 18.9±11.1 months (range, 12–60 months). Three patients (6.5%) were lost to follow-up. Conclusions Implant-associated infections of long-segment spinal instrumentations are associated with high complication and mortality rates. Late infections are associated with implant removal. Treatment should be interdisciplinary including orthopedic surgeons and clinical infectiologists. spinal infection implant-associated infection long-segmental spinal instrumentation deep surgical site infection Medicine R Lisa Altenrath verfasserin aut Leonard Westermann verfasserin aut Jan Bredow verfasserin aut Peer Eysel verfasserin aut Max Joseph Scheyerer verfasserin aut In Asian Spine Journal Korean Spine Society, 2018 15(2021), 2, Seite 234-243 (DE-627)60349207X (DE-600)2502303-2 19767846 nnns volume:15 year:2021 number:2 pages:234-243 https://doi.org/10.31616/asj.2019.0391 kostenfrei https://doaj.org/article/01bd0b25815948d88a9b0863fb006a39 kostenfrei http://www.asianspinejournal.org/upload/pdf/asj-2019-0391.pdf kostenfrei https://doaj.org/toc/1976-1902 Journal toc kostenfrei https://doaj.org/toc/1976-7846 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2021 2 234-243
allfieldsSound	10.31616/asj.2019.0391 doi (DE-627)DOAJ05207076X (DE-599)DOAJ01bd0b25815948d88a9b0863fb006a39 DE-627 ger DE-627 rakwb eng Stavros Oikonomidis verfasserin aut Implant-Associated Infection of Long-Segment Spinal Instrumentation: A Retrospective Analysis of 46 Consecutive Patients 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Study Design This single-center retrospective study analyzed patients with an implant-associated infection of spinal instrumentation (four or more segments) treated between 2010 and 2018. Purpose This study aimed to investigate the treatment of implant-associated infections of long-segment spinal instrumentation and to define risk factors for implant removal. Overview of Literature Implant-associated infection occurs in 0.7%–20% of spinal instrumentation. Significant blood loss, delayed reoperation, and use of effective antibiotics are reported risk factors for implant removal. Methods Patients with superficial infections not involving the implant were excluded. All patients received surgical and antibiotic treatments according to our interdisciplinary osteomyelitis board protocol. An infection was considered healed if a patient showed no signs of infection 1 year after termination of treatment. The patients were divided into an implant retention group and implant removal group, and their clinical and microbiological data were compared. Results Forty-six patients (27 women, 19 men) with an implant-associated infection of long-segment spinal instrumentation and mean age of 65.3±14.3 years (range, 22–89 years) were included. The mean length of the infected instrumentation was 6.5±2.4 segments (range, 4–13 segments). Implant retention was possible in 21 patients (45.7%); in the other 25 patients (54.3%), a part of or the entire implant required removal. Late infections were associated with implant removal, which correlated with longer hospitalization. Both groups showed high postoperative complication rates (50%) and high mortality rates (8.7%). In 39 patients (84.8%), infection was eradicated at a mean follow-up of 18.9±11.1 months (range, 12–60 months). Three patients (6.5%) were lost to follow-up. Conclusions Implant-associated infections of long-segment spinal instrumentations are associated with high complication and mortality rates. Late infections are associated with implant removal. Treatment should be interdisciplinary including orthopedic surgeons and clinical infectiologists. spinal infection implant-associated infection long-segmental spinal instrumentation deep surgical site infection Medicine R Lisa Altenrath verfasserin aut Leonard Westermann verfasserin aut Jan Bredow verfasserin aut Peer Eysel verfasserin aut Max Joseph Scheyerer verfasserin aut In Asian Spine Journal Korean Spine Society, 2018 15(2021), 2, Seite 234-243 (DE-627)60349207X (DE-600)2502303-2 19767846 nnns volume:15 year:2021 number:2 pages:234-243 https://doi.org/10.31616/asj.2019.0391 kostenfrei https://doaj.org/article/01bd0b25815948d88a9b0863fb006a39 kostenfrei http://www.asianspinejournal.org/upload/pdf/asj-2019-0391.pdf kostenfrei https://doaj.org/toc/1976-1902 Journal toc kostenfrei https://doaj.org/toc/1976-7846 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2021 2 234-243
language	English
source	In Asian Spine Journal 15(2021), 2, Seite 234-243 volume:15 year:2021 number:2 pages:234-243
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author	Stavros Oikonomidis
spellingShingle	Stavros Oikonomidis misc spinal infection misc implant-associated infection misc long-segmental spinal instrumentation misc deep surgical site infection misc Medicine misc R Implant-Associated Infection of Long-Segment Spinal Instrumentation: A Retrospective Analysis of 46 Consecutive Patients
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topic_title	Implant-Associated Infection of Long-Segment Spinal Instrumentation: A Retrospective Analysis of 46 Consecutive Patients spinal infection implant-associated infection long-segmental spinal instrumentation deep surgical site infection
topic	misc spinal infection misc implant-associated infection misc long-segmental spinal instrumentation misc deep surgical site infection misc Medicine misc R
topic_unstemmed	misc spinal infection misc implant-associated infection misc long-segmental spinal instrumentation misc deep surgical site infection misc Medicine misc R
topic_browse	misc spinal infection misc implant-associated infection misc long-segmental spinal instrumentation misc deep surgical site infection misc Medicine misc R
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title	Implant-Associated Infection of Long-Segment Spinal Instrumentation: A Retrospective Analysis of 46 Consecutive Patients
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title_full	Implant-Associated Infection of Long-Segment Spinal Instrumentation: A Retrospective Analysis of 46 Consecutive Patients
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journal	Asian Spine Journal
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author_browse	Stavros Oikonomidis Lisa Altenrath Leonard Westermann Jan Bredow Peer Eysel Max Joseph Scheyerer
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format_se	Elektronische Aufsätze
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doi_str_mv	10.31616/asj.2019.0391
author2-role	verfasserin
title_sort	implant-associated infection of long-segment spinal instrumentation: a retrospective analysis of 46 consecutive patients
title_auth	Implant-Associated Infection of Long-Segment Spinal Instrumentation: A Retrospective Analysis of 46 Consecutive Patients
abstract	Study Design This single-center retrospective study analyzed patients with an implant-associated infection of spinal instrumentation (four or more segments) treated between 2010 and 2018. Purpose This study aimed to investigate the treatment of implant-associated infections of long-segment spinal instrumentation and to define risk factors for implant removal. Overview of Literature Implant-associated infection occurs in 0.7%–20% of spinal instrumentation. Significant blood loss, delayed reoperation, and use of effective antibiotics are reported risk factors for implant removal. Methods Patients with superficial infections not involving the implant were excluded. All patients received surgical and antibiotic treatments according to our interdisciplinary osteomyelitis board protocol. An infection was considered healed if a patient showed no signs of infection 1 year after termination of treatment. The patients were divided into an implant retention group and implant removal group, and their clinical and microbiological data were compared. Results Forty-six patients (27 women, 19 men) with an implant-associated infection of long-segment spinal instrumentation and mean age of 65.3±14.3 years (range, 22–89 years) were included. The mean length of the infected instrumentation was 6.5±2.4 segments (range, 4–13 segments). Implant retention was possible in 21 patients (45.7%); in the other 25 patients (54.3%), a part of or the entire implant required removal. Late infections were associated with implant removal, which correlated with longer hospitalization. Both groups showed high postoperative complication rates (50%) and high mortality rates (8.7%). In 39 patients (84.8%), infection was eradicated at a mean follow-up of 18.9±11.1 months (range, 12–60 months). Three patients (6.5%) were lost to follow-up. Conclusions Implant-associated infections of long-segment spinal instrumentations are associated with high complication and mortality rates. Late infections are associated with implant removal. Treatment should be interdisciplinary including orthopedic surgeons and clinical infectiologists.
abstractGer	Study Design This single-center retrospective study analyzed patients with an implant-associated infection of spinal instrumentation (four or more segments) treated between 2010 and 2018. Purpose This study aimed to investigate the treatment of implant-associated infections of long-segment spinal instrumentation and to define risk factors for implant removal. Overview of Literature Implant-associated infection occurs in 0.7%–20% of spinal instrumentation. Significant blood loss, delayed reoperation, and use of effective antibiotics are reported risk factors for implant removal. Methods Patients with superficial infections not involving the implant were excluded. All patients received surgical and antibiotic treatments according to our interdisciplinary osteomyelitis board protocol. An infection was considered healed if a patient showed no signs of infection 1 year after termination of treatment. The patients were divided into an implant retention group and implant removal group, and their clinical and microbiological data were compared. Results Forty-six patients (27 women, 19 men) with an implant-associated infection of long-segment spinal instrumentation and mean age of 65.3±14.3 years (range, 22–89 years) were included. The mean length of the infected instrumentation was 6.5±2.4 segments (range, 4–13 segments). Implant retention was possible in 21 patients (45.7%); in the other 25 patients (54.3%), a part of or the entire implant required removal. Late infections were associated with implant removal, which correlated with longer hospitalization. Both groups showed high postoperative complication rates (50%) and high mortality rates (8.7%). In 39 patients (84.8%), infection was eradicated at a mean follow-up of 18.9±11.1 months (range, 12–60 months). Three patients (6.5%) were lost to follow-up. Conclusions Implant-associated infections of long-segment spinal instrumentations are associated with high complication and mortality rates. Late infections are associated with implant removal. Treatment should be interdisciplinary including orthopedic surgeons and clinical infectiologists.
abstract_unstemmed	Study Design This single-center retrospective study analyzed patients with an implant-associated infection of spinal instrumentation (four or more segments) treated between 2010 and 2018. Purpose This study aimed to investigate the treatment of implant-associated infections of long-segment spinal instrumentation and to define risk factors for implant removal. Overview of Literature Implant-associated infection occurs in 0.7%–20% of spinal instrumentation. Significant blood loss, delayed reoperation, and use of effective antibiotics are reported risk factors for implant removal. Methods Patients with superficial infections not involving the implant were excluded. All patients received surgical and antibiotic treatments according to our interdisciplinary osteomyelitis board protocol. An infection was considered healed if a patient showed no signs of infection 1 year after termination of treatment. The patients were divided into an implant retention group and implant removal group, and their clinical and microbiological data were compared. Results Forty-six patients (27 women, 19 men) with an implant-associated infection of long-segment spinal instrumentation and mean age of 65.3±14.3 years (range, 22–89 years) were included. The mean length of the infected instrumentation was 6.5±2.4 segments (range, 4–13 segments). Implant retention was possible in 21 patients (45.7%); in the other 25 patients (54.3%), a part of or the entire implant required removal. Late infections were associated with implant removal, which correlated with longer hospitalization. Both groups showed high postoperative complication rates (50%) and high mortality rates (8.7%). In 39 patients (84.8%), infection was eradicated at a mean follow-up of 18.9±11.1 months (range, 12–60 months). Three patients (6.5%) were lost to follow-up. Conclusions Implant-associated infections of long-segment spinal instrumentations are associated with high complication and mortality rates. Late infections are associated with implant removal. Treatment should be interdisciplinary including orthopedic surgeons and clinical infectiologists.
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title_short	Implant-Associated Infection of Long-Segment Spinal Instrumentation: A Retrospective Analysis of 46 Consecutive Patients
url	https://doi.org/10.31616/asj.2019.0391 https://doaj.org/article/01bd0b25815948d88a9b0863fb006a39 http://www.asianspinejournal.org/upload/pdf/asj-2019-0391.pdf https://doaj.org/toc/1976-1902 https://doaj.org/toc/1976-7846
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author2	Lisa Altenrath Leonard Westermann Jan Bredow Peer Eysel Max Joseph Scheyerer
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up_date	2024-07-03T23:36:10.265Z
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