Study Design: 

Retrospective data analysis.

Objection: 

The primary objective of this investigation was to analyze if treatment of Postoperative surgical site infections (PSSI) after posterior stabilization of the spine (PS) without radiological signs of screw loosening (RSL) shows a sufficient success rate without implant removal and if there was any difference between early and late PSSI.

Summary of Background Data: 

PSSI after PS are usually treated by implant removal and reinstrumentation if loosening of one of more screws is detected. There is presently no conclusive data that shows the success rate of the treatment of PSSI after PS without implant removal if no RSL are perceived.

Materials and Methods: 

All patients who were treated for a PSSI after PS without RSL in a single spine center from 12/2009 to 03/2020 were enrolled in a retrospective analysis. Patients were treated by revision surgery with debridement and irrigation and subsequent antibiotic therapy. Implant removal was performed if the initial treatment did not lead to an improvement in wound healing and normalization of laboratory values. Statistical analysis was performed by Statistical Package for the Social Sciences 25. Descriptive data are given as mean and standard error of mean, a χ² test was performed.

Results: 

Of the 32 enrolled patients, 17 had an early PSSI, 15 a late PSSI. In 71.9% (23/32), the PSSI was treated without implant removal: 12/17 in early PSSI, 11/15 in late PSSI. The difference was not significant (P>0.05). One patient died, all other patients were discharged from the hospital with no remaining laboratory signs of the infection and with closed soft tissues.

Conclusions: 

In our group of patients, the success rate of irrigation and debridement without implant removal was 71.9%. In the light of this data, performing at least two irrigations and debridement before implant removal seems to be a valid treatment option in PSSI after PS if there are no RSL in early and late PSSI.

中文翻译：

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脊柱后路稳定后的手术部位感染 – 我们什么时候必须移除植入物？

学习规划： 

回顾性数据分析。

异议： 

本次调查的主要目的是分析在脊柱后部稳定 (PS) 后，在没有螺钉松动 (RSL) 放射学迹象的情况下，治疗术后手术部位感染 (PSSI) 是否显示出足够的成功率，无需移除植入物，以及是否存在任何问题早期和晚期 PSSI 之间的差异。

背景数据摘要： 

PS 后的 PSSI 通常通过移除种植体进行治疗，如果检测到其中一颗螺钉松动，则重新植入。目前没有确凿的数据表明，如果没有感觉到 RSL， PS 后不移除种植体的 PSSI 治疗的成功率。

材料和方法： 

2009 年 12 月至 2020 年 3 月期间，所有在单一脊柱中心接受 PSSI 治疗但未接受 RSL 的患者均纳入回顾性分析。患者接受修复手术、清创和冲洗以及随后的抗生素治疗。如果初始治疗没有改善伤口愈合和实验室值正常化，则进行植入物移除。统计分析由Statistical Package for the Social Sciences 25进行。描述性数据以平均值和平均值的标准误给出，并进行χ ^2检验。

结果： 

在 32 名入组患者中，17 名患有早期 PSSI，15 名患有晚期 PSSI。71.9% (23/32) 的 PSSI 患者在不移除种植体的情况下进行治疗：早期 PSSI 为 12/17，晚期 PSSI 为 11/15。差异不显着（P >0.05）。一名患者死亡，所有其他患者均已出院，没有留下感染的实验室迹象，且软组织闭合。

结论： 

在我们组的患者中，不移除种植体的冲洗清创成功率为71.9%。根据这些数据，如果早期和晚期 PSSI 中没有 RSL，则在移除种植体之前进行至少两次冲洗和清创似乎是 PS 术后 PSSI 的有效治疗选择。