Risk factors for implant removal after spinal surgical site infection View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-10

AUTHORS

Naoya Tsubouchi, Shunsuke Fujibayashi, Bungo Otsuki, Masanori Izeki, Hiroaki Kimura, Masato Ota, Takeshi Sakamoto, Akira Uchikoshi, Shuichi Matsuda

ABSTRACT

PURPOSE: Few studies have investigated the risk factors for implant removal after treatment for spinal surgical site infection (SSI). Therefore, there is no firmly established consensus for the management of implants. We aimed to investigate the incidence and risk factors for implant removal after SSI managed with instrumentation, and to examine potential strategies for avoiding implant removal. METHODS: Following a survey of seven spine centers, we retrospectively reviewed the records of 55 patients who developed SSI and were treated with reoperation, out of 3967 patients who had spinal instrumentation between 2003 and 2012. We examined implant survival rate and applied logistic regression analysis to assess the potential risk factors for implant removal. RESULTS: The overall rate of implant retention was 60% (33/55). A higher implant retention rate was observed for posterior cervical surgery than for posterior-thoracic/lumbar surgery (100 vs. 49%, P < 0.001). On univariate analysis, significant risk factors for implant removal included greater blood loss, delay of reoperation, and delay of intervention with effective antibiotics. Multivariate analysis revealed that a delay in administering effective antibiotics was an independent and significant risk factor for implant removal in posterior-thoracic/lumbar surgery (odds ratio 1.17; 95% confidence interval 1.02-1.35, P = 0.028). CONCLUSIONS: Patients with SSI who underwent posterior cervical surgery are likely to retain the implants. Immediate administration of effective antibiotics improves implant survival in SSI treatment. Our findings can be applied to identify SSI patients at higher risk for implant removal. More... »

PAGES

2481-2490

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00586-017-5294-1

DOI

http://dx.doi.org/10.1007/s00586-017-5294-1

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1091762906

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/28913559


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    "description": "PURPOSE: Few studies have investigated the risk factors for implant removal after treatment for spinal surgical site infection (SSI). Therefore, there is no firmly established consensus for the management of implants. We aimed to investigate the incidence and risk factors for implant removal after SSI managed with instrumentation, and to examine potential strategies for avoiding implant removal.\nMETHODS: Following a survey of seven spine centers, we retrospectively reviewed the records of 55 patients who developed SSI and were treated with reoperation, out of 3967 patients who had spinal instrumentation between 2003 and 2012. We examined implant survival rate and applied logistic regression analysis to assess the potential risk factors for implant removal.\nRESULTS: The overall rate of implant retention was 60% (33/55). A higher implant retention rate was observed for posterior cervical surgery than for posterior-thoracic/lumbar surgery (100 vs. 49%, P\u00a0<\u00a00.001). On univariate analysis, significant risk factors for implant removal included greater blood loss, delay of reoperation, and delay of intervention with effective antibiotics. Multivariate analysis revealed that a delay in administering effective antibiotics was an independent and significant risk factor for implant removal in posterior-thoracic/lumbar surgery (odds ratio 1.17; 95% confidence interval 1.02-1.35, P\u00a0=\u00a00.028).\nCONCLUSIONS: Patients with SSI who underwent posterior cervical surgery are likely to retain the implants. Immediate administration of effective antibiotics improves implant survival in SSI treatment. Our findings can be applied to identify SSI patients at higher risk for implant removal.", 
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