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Document Type

Original Article

Abstract

Background: Wound infection still has a negative impact on patient outcomes after spine surgery, despite the discovery of preventative medicines as well as improvements in surgical approach and postoperative care. The risk of intraoperative/postoperative infection is increased by utilizing a posterior surgical approach, applying instrumentation, using an allograft, requiring a blood transfusion, and longer operations.

Aim of the study: To determine the prevalence and risk factors for post-operative instrumental lumbar spinal infection and evaluate functional outcomes after the management of the infections.

Patients and Methods: This study was conducted on diseased persons whom had an infection after lumbar spine instrumentation surgery and attended to Al-Azhar University Hospitals during the time of the study.

Results: Our results revealed that approximately 4% of patients had post-spinal implantation infections. The risk factors for postoperative infection included older patients, female gender, obesity, smoking, hyperglycemia, diabetes mellitus, chronic obstructive disease, postoperative urinary incontinence, increasing the duration of surgery, blood loss during operation, blood transfusion, postoperative hospital stay, and posterior approach. 65% of included patients underwent surgical debridement. 35% of the patients that were included had implants removed. The improvement in ASIA score was observed in 87.5% of included patients. After infection management, 65% of patients had a minimal disability.

Conclusion: There were various risk factors for infection including patient-related and surgery-related. Therefore, special attention should be paid to reducing the influence of risk factors on the occurrence of infection. The infection treatment using antibiotics, debridement, or implant improved functional outcomes and reduced disability in about 88% of included patients.

Keywords

infection, spinal implant, disability, mortality, risk factors

Subject Area

Orthopedics

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