AO Spine Clinical Experts Advice Forum - The management of early post-operative spinal infection in the presence of implants, interbody cages, and bone grafting
Post-operative surgical site infection is a potentially devastating complication that can compromise patient out comes and result in pseudarthrosis and adverse neurologic sequelae. In addition, it leads to increased utilization of healthcare resources and prolonged hospitalization.
In spine fusion surgery, SSI is further complicated by instrumentation and implants such as rods, screws, and cages that are necessary to achieve stability until fusion has occurred. Implants are foreign bodies that provide a favorable environment for adhesion of bacteria with multi-layered cell proliferation and subsequent biofilm formation, allowing infection to evade the host immune response.
Detecting initial signs of infection, establishing the diagnosis, performing irrigation and wound debridement, and starting appropriate antibiotic therapy in a timely fashion is imperative to controlling infection and increasing the chances of salvaging spinal implants