Format

Send to

Choose Destination
Clin Infect Dis. 2007 Apr 1;44(7):913-20. Epub 2007 Feb 14.

The management and outcome of spinal implant infections: contemporary retrospective cohort study.

Author information

1
Division of Infectious Diseases, Gundersen Lutheran Medical Center, LaCrosse, WI 54601, USA. tjkowals@gundluth.org

Abstract

BACKGROUND:

Spinal implant infections provide unique diagnostic and therapeutic challenges.

METHODS:

We conducted a retrospective cohort study to evaluate risk factors for treatment failure in patients with early- and late-onset spinal implant infections at the Mayo Clinic (Rochester, MN) during 1994-2002.

RESULTS:

We identified 30 patients with early-onset spinal implant infection and 51 patients with late-onset spinal implant infection. Twenty-eight of 30 patients with early-onset infection were treated with debridement, implant retention, and antimicrobial therapy. The estimated 2-year cumulative probability of survival free of treatment failure for patients with early-onset infection was 71% (95% confidence interval [CI], 51%-85%). Thirty-two of 51 patients with late-onset infection were treated with implant removal. Their estimated 2-year cumulative probability of survival free of treatment failure was 84% (95% CI, 66%-93%). For patients with early-onset infections, receiving oral antimicrobial suppression therapy was associated with increased cumulative probability of survival (hazard ratio, 0.2; 95% CI, 0.1-0.7). For patients with late-onset infections, implant removal was associated with increased cumulative probability of survival (hazard ratio, 0.3; 95% CI, 0.1-0.7).

CONCLUSIONS:

Early-onset spinal implant infections are successfully treated with debridement, implant retention, and parenteral followed by oral suppressive antimicrobial therapy. Implant removal is associated with successful outcomes in late-onset infections.

PMID:
17342641
DOI:
10.1086/512194
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center