Spinal Implants Can Be Inserted in Patients with Deep Spine Infection

Hwee Weng Dennis Hey, Li Wen Nathaniel Ng, Chuen Seng Tan, Dale Fisher, Anupama Vasudevan, Ka Po Gabriel Liu, Joseph Shantakumar Thambiah, Naresh Kumar, Leok Lim Lau, Hee Kit Wong, Paul Anantharajah Tambyah

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5 Citations (Scopus)

Abstract

Study Design. A retrospective, cohort study of 84 patients with deep spine infection managed at a major tertiary hospital over 14 years with a minimum follow up of 2 years. Objective. To determine the role of instrumentation in spines with deep infection. Summary of Background Data. It is often believed that implants should not be inserted in patients with deep spine infection because of the risk of persistent or recurrent infection. However, there are often concerns about spinal stability and a paucity of evidence to guide clinical practice in this field. Methods. We compared the mortality, reoperation, and reinfection rates in patients with spine infection treated with antibiotics alone, antibiotics with debridement, and antibiotics with debridement and instrumentation. Significant outcome predictors were determined using multivariable logistic regression model. Results. Forty-nine males and 35 females with a mean age was 62.0 years had spine infection affecting the lumbar spine predominantly. The most common form of infection was osteomyelitis and spondylodiscitis (69.4%). Staphylococcus aureus was the most common causative organism (61.2%). There was no difference in terms of reoperation or relapse for patients treated with antibiotics alone, antibiotics with debridement, or antibiotics with debridement and instrumentation. However, compared with antibiotics alone, the crude inhospital mortality was lower for patients treated with instrumentation (odds ratio, OR, 0.82; P = 0.01), and antibiotics with debridement (OR 0.80; P = 0.02). Conclusion. Spinal instrumentation in an infected spine is safe and not associated with higher reoperation or relapse rates. Mortality is lower for patients treated with instrumentation.

Original languageEnglish
Pages (from-to)E490-E495
Number of pages6
JournalSpine
Volume42
Issue number8
DOIs
Publication statusPublished - 15 Apr 2017
Externally publishedYes

Keywords

  • debridement
  • deep spine infection
  • instrumentation
  • mortality
  • recurrence
  • relapse
  • reoperation

Cite this

Dennis Hey, H. W., Nathaniel Ng, L. W., Tan, C. S., Fisher, D., Vasudevan, A., Liu, K. P. G., Thambiah, J. S., Kumar, N., Lau, L. L., Wong, H. K., & Tambyah, P. A. (2017). Spinal Implants Can Be Inserted in Patients with Deep Spine Infection. Spine, 42(8), E490-E495. https://doi.org/10.1097/BRS.0000000000001747