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Late implant infections caused by Propionibacterium acnes in scoliosis surgery


Hahn, Frederik; Zbinden, Reinhard; Min, Kan (2005). Late implant infections caused by Propionibacterium acnes in scoliosis surgery. European Spine Journal, 14(8):783-788.

Abstract

One hundred and one consecutive adolescent scoliosis patients instrumented from the posterior between 1995 and 2002, with a minimum follow-up of 24months (maximum 106months), were reviewed for incidence of infection. Stainless steel implants with pedicle screws were used in the thoracic and lumbar spine of all patients. All were operated on by a single surgeon. There were no early infections. Incidence of late infection was 6.9% (seven patients). Clinical indicators for infection were the sudden onset of local pain and swelling without fever after an initial pain-free interval. There were no reliable laboratory parameters. Normal CRP and ESR did not rule out a late infection. Extended cultures were done from intraoperative swabs. Propionibacterium acnes was found in six patients. There were no other organisms identified. No causative organism could be identified in one patient, despite extended cultures. All patients were successfully treated with implant removal and antibiotic therapy for 4-9weeks. No pseudarthrosis was seen on implant removal. Despite bony fusion, loss of correction between 10° and 26° was observed in three patients after implant removal

Abstract

One hundred and one consecutive adolescent scoliosis patients instrumented from the posterior between 1995 and 2002, with a minimum follow-up of 24months (maximum 106months), were reviewed for incidence of infection. Stainless steel implants with pedicle screws were used in the thoracic and lumbar spine of all patients. All were operated on by a single surgeon. There were no early infections. Incidence of late infection was 6.9% (seven patients). Clinical indicators for infection were the sudden onset of local pain and swelling without fever after an initial pain-free interval. There were no reliable laboratory parameters. Normal CRP and ESR did not rule out a late infection. Extended cultures were done from intraoperative swabs. Propionibacterium acnes was found in six patients. There were no other organisms identified. No causative organism could be identified in one patient, despite extended cultures. All patients were successfully treated with implant removal and antibiotic therapy for 4-9weeks. No pseudarthrosis was seen on implant removal. Despite bony fusion, loss of correction between 10° and 26° was observed in three patients after implant removal

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:National licences > 142-005
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:1 October 2005
Deposited On:24 Oct 2018 09:31
Last Modified:28 Oct 2018 21:36
Publisher:Springer
ISSN:0940-6719
OA Status:Green
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1007/s00586-004-0854-6
Related URLs:https://www.swissbib.ch/Search/Results?lookfor=nationallicencespringer101007s0058600408546 (Library Catalogue)

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