Abstract：
Late infection following posterior spinal fusion (PSF) for deformity is a leading cause of revision. The purpose of this study is to evaluate clinical and radiographic outcomes following a single-stage debridement and exchange of spinal implants with titanium in adolescent patients with late-onset infections following PSF METHODS: A retrospective review of prospectively collected data of adolescent patients with spinal deformity, who were surgically treated with PSF was collected. Patients were included for the study if they developed late arising infection (> 1 year after index posterior fusion for the deformity) from 2006-2019. Treatment consisted of irrigation, debridement, implant exchange with titanium screws and rods, and antibiotics. Parameters evaluated include radiographic Cobb angles, operative data, and clinical data, all at minimum 2-year follow-up.
31 patients (29 with AIS and 2 with Scheuermann\'s kyphosis) developed late spinal infections. Mean age was 11.4 ± 2.3 years, 84% female, mean time from index surgery was 52.5 months. 25 had all stainless steel implants and 6 had cobalt chrome during the index procedure. Positive cultures were obtained in 5 patients (2 Staphylococcus Aureus, 1 Staphylococcus epidermidis, 1 Peptostreptococcus, 1 Pseudomonas aeruginosa) with cultures followed till 7 days post-operatively. At 2-years following the exchange, there was no change in coronal and sagittal alignment. Three (9%) patients developed subsequent infection necessitating implant removal.
A single-stage procedure consisting of implant removal, irrigation, and debridement, and replacement with all titanium implants is an effective treatment strategy in patients developing late wound infection following PSF with regards to maintenance of curve correction and minimizing recurrent infections.
31 patients (29 with AIS and 2 with Scheuermann\'s kyphosis) developed late spinal infections. Mean age was 11.4 ± 2.3 years, 84% female, mean time from index surgery was 52.5 months. 25 had all stainless steel implants and 6 had cobalt chrome during the index procedure. Positive cultures were obtained in 5 patients (2 Staphylococcus Aureus, 1 Staphylococcus epidermidis, 1 Peptostreptococcus, 1 Pseudomonas aeruginosa) with cultures followed till 7 days post-operatively. At 2-years following the exchange, there was no change in coronal and sagittal alignment. Three (9%) patients developed subsequent infection necessitating implant removal.
A single-stage procedure consisting of implant removal, irrigation, and debridement, and replacement with all titanium implants is an effective treatment strategy in patients developing late wound infection following PSF with regards to maintenance of curve correction and minimizing recurrent infections.
摘要：
后路脊柱融合术（PSF）后畸形的晚期感染是翻修的主要原因。这项研究的目的是评估临床和影像学结果，在单阶段清创和更换脊柱植入物与PSF方法后晚发性感染的青少年患者：回顾性回顾前瞻性收集的青少年患者的数据脊柱畸形，收集接受PSF手术治疗的患者。如果患者从2006年至2019年发展为迟发性感染（在畸形的索引后路融合后>1年），则将其纳入研究。治疗包括灌溉，清创术,植入物与钛螺钉和棒交换，和抗生素。评估的参数包括射线照相Cobb角，手术数据,和临床数据，至少2年随访。
31例患者（29例AIS和2例Scheuermann后凸畸形）发生晚期脊柱感染。平均年龄11.4±2.3岁,84%女性，从索引手术开始的平均时间为52.5个月.在索引过程中,25个具有全部不锈钢植入物,6个具有钴铬合金。5例患者获得阳性培养物（2例金黄色葡萄球菌，1表皮葡萄球菌，1肽链球菌，1铜绿假单胞菌）并进行培养，直到术后7天。在交换后的两年里，冠状和矢状排列没有变化。三名（9％）患者随后发生感染，需要移除植入物。
单阶段手术包括移除植入物，灌溉,清创,对于PSF后出现晚期伤口感染的患者，在维持曲线校正和最大程度地减少复发性感染方面，使用全钛植入物替换是一种有效的治疗策略。
31例患者（29例AIS和2例Scheuermann后凸畸形）发生晚期脊柱感染。平均年龄11.4±2.3岁,84%女性，从索引手术开始的平均时间为52.5个月.在索引过程中,25个具有全部不锈钢植入物,6个具有钴铬合金。5例患者获得阳性培养物（2例金黄色葡萄球菌，1表皮葡萄球菌，1肽链球菌，1铜绿假单胞菌）并进行培养，直到术后7天。在交换后的两年里，冠状和矢状排列没有变化。三名（9％）患者随后发生感染，需要移除植入物。
单阶段手术包括移除植入物，灌溉,清创,对于PSF后出现晚期伤口感染的患者，在维持曲线校正和最大程度地减少复发性感染方面，使用全钛植入物替换是一种有效的治疗策略。
