Post-Operative Wound Infection after Instrumentation and Fusion of Thoracic and Lumbar Fractures

Abstract

Infection rates for elective spine surgeries are well established, however, literature on postoperative wound infections following surgeries for thoracolumbar fractures are rare. Unstable fracture and fracture dislocations frequently require instrumentation and fusion over multiple levels or a combined anterior and posterior approach. Subjecting acutely injured patients to these extensive procedures increases the risk of post-operative wound infections. Factors that increase this risk include the administration of steroids, extensive dissection during surgery, prolonged operative times, malnutrition, smoking, advanced age, presence of associated medical conditions and history of prior back surgery.

Treatment in our center for an established post-operative spine infection consists of early exploration, multiple debridements and irrigation with implantation of antibiotic impregnated beads, and prolonged intravenous antibiotic administration. This treatment protocol has allowed us to salvage the instrumentation, with the majority of patients going on to fusion.

Key words

Spine - trauma - morbidity - infection

References

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