Management of Infection After Instrumented Posterior Spine Fusion in Pediatric Scoliosis

• DOI: 10.1097/brs.0b013e31815a5a86
• Publication Date: 2009-03-05T01:43:46Z
• Authors: Christine Ho; David L. Skaggs; Jennifer M. Weiss; Vernon T. Tolo
• Keywords: Medical record; Rachis; Debridement (dental)

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