caa a22 4500 445833165 CHVBK 20180317145322.0 cr unu---uuuuu 170323e20110501xx s 000 0 eng 10.1007/s00586-011-1754-1 doi (NATIONALLICENCE)springer-10.1007/s00586-011-1754-1 Late-developing infection following posterior fusion for adolescent idiopathic scoliosis [Elektronische Daten] [Mario Silvestre, Georgios Bakaloudis, Francesco Lolli, Stefano Giacomini] This study is a retrospective case series review of patients with adolescent idiopathic scoliosis (AIS) who were revised more than 1year after the index procedure, due to a late-developing deep wound infection, to determine onset, bacteriology, possible influence of implant alloy (titanium vs. stainless-steel) and treatment outcome of patients. From a total of 540 patients who underwent posterior-only fusion for AIS from 1993 through 2005 at our institution, 15 cases (2.77%) were revised due to a late-developing post-operative infection: there were six males and nine females, with an average age at initial surgery of 15.8years (range 12-18). Late infections occurred at a mean of 70months (15-95) after the index procedure. The implant alloy used was a stainless-steel instrumentation in 11 patients (4.56% of 241) and a titanium one in 4 patients (1.33% of 299): there was an higher incidence of late infections in stainless-steel alloy group of patients (P<0.0001). Complete removal of instrumentation was performed in nine patients, obtaining in all cases wound healing and no symptoms of infection, at a minimum 3years follow-up. In the other six patients, presenting less severe clinical signs of infections, an attempt to save/replace the previous instrumentation was performed, but a complete instrumentation removal had to be performed 11.6months later (range 3-24) for the persistence or recurrence of infection: all patients healed uneventfully at a minimum 3years follow-up. Intraoperative cultures were obtained in all 15 cases, being positive in 13 cases (S. epidermidis in 5 patients, S. aureus in 3, Propionibacterium acnes in 1, Serratia marcescens in 1, Propionibacterium acnes+S. epidermidis in 1, S. aureus+S. epidermidis in 1 and coagulase-negative Staphylococci in 1). None presented at latest follow-up scoliosis progression: there was no statistically significant difference between final and pre-operative revision surgery values (P=0.17). In conclusion, treatment of late-developing post-operative infection in AIS surgery required complete removal of the implant, continuous drain and adequate antibiotic therapy based on intraoperative swab antibiogram. Titanium alloy instrumentations resulted less subject to late post-operative infections, when compared to stainless-steel ones (P<0.0001). Springer-Verlag, 2011 Adolescent idiopathic scoliosis nationallicence Posterior fusion nationallicence Late-developing infection nationallicence Silvestre Mario Spine Surgery Department, Istituti Ortopedici Rizzoli, Via Pupilli 1, 40136, Bologna, Italy aut Bakaloudis Georgios Spine Surgery Department, Istituti Ortopedici Rizzoli, Via Pupilli 1, 40136, Bologna, Italy aut Lolli Francesco Spine Surgery Department, Istituti Ortopedici Rizzoli, Via Pupilli 1, 40136, Bologna, Italy aut Giacomini Stefano Spine Surgery Department, Istituti Ortopedici Rizzoli, Via Pupilli 1, 40136, Bologna, Italy aut European Spine Journal Springer-Verlag 20(2011-05-01), 121-127 0940-6719 20<121 2011 20 586 https://doi.org/10.1007/s00586-011-1754-1 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00586-011-1754-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Silvestre Mario Spine Surgery Department, Istituti Ortopedici Rizzoli, Via Pupilli 1, 40136, Bologna, Italy aut NATIONALLICENCE 700 1- Bakaloudis Georgios Spine Surgery Department, Istituti Ortopedici Rizzoli, Via Pupilli 1, 40136, Bologna, Italy aut NATIONALLICENCE 700 1- Lolli Francesco Spine Surgery Department, Istituti Ortopedici Rizzoli, Via Pupilli 1, 40136, Bologna, Italy aut NATIONALLICENCE 700 1- Giacomini Stefano Spine Surgery Department, Istituti Ortopedici Rizzoli, Via Pupilli 1, 40136, Bologna, Italy aut NATIONALLICENCE 773 0- European Spine Journal Springer-Verlag 20(2011-05-01), 121-127 0940-6719 20<121 2011 20 586 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer