Spinal Implants Can Be Retained in Patients with Deep Spine Infection: A Cohort Study

Background/Purpose: It is unclear whether implant removal is necessary when deep spine infection of spinal instrumentation occurs. This study compares mortality, relapse, and reoperation rates between such patients with and without removal of spine implants. Methods: A total of 20 patients were retrospectively reviewed. Baseline characteristics of the implant removal and nonremoval groups were compared. Outcome measures between groups were compared using multivariable logistic regression and predictors of each outcome identified. Results: There were no significant differences in mortality, relapse, or reoperation rates between groups. Multiple vertebral level involvement was common (85%), and the L4 (30%) and L5 (35%) levels were most commonly involved. The majority of patients had osteomyelitis/spondylodiscitis (50%) and Staphylococcus aureus infections (60%). Thoracic spine infection was associated with relapse (odds ratio = 1.26) and reoperation (odds ratio = 1.101). Conclusion: Implant removal is not always necessary in cases of deep spine infection as retention of implants is not associated with higher mortality, relapse, or reoperation rates. 中 文 摘 要: 背景/目的: 目前還不清楚是否需要在已有脊柱內固定植入物發生深層脊椎感染時將脊柱植入物移除。這項研究比較了有移除或沒有移除脊柱植入物的患者之間的死亡率、復發率和再手術率。 方法: 回顧性分析20例受試者。比較植入物去除和未去除組別的基線特徵。以多變量邏輯和預測因子將兩組別每個確定的結果測量進行比較。 結果: 兩組別之間的死亡率、復發率或再手術率無 統計學意義的差異。多站點脊椎發生是常見的(85%)。L4(30%)和L5(35%) 最常見的。大多數患者有骨髓炎/脊椎椎間盤炎 (50%) 和金黃葡萄球菌感染(60%)。胸椎感染與復發 (OR=1.26) 和再次手術 (OR=1.101)有關。 Keywords: deep spine infection, implant removal, mortality, relapse, reoperation, spinal implant