gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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Low-grade infection in spinal instrumentation: Is this the real cause of screw loosening?

Meeting Abstract

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  • Ehab Shiban - Klinikum rechts der Isar TU München , München, Deutschland
  • Insa Janssen - Klinikum rechts der Isar TU München , Munich, Deutschland
  • Issa Mohammed - Klinikum rechts der Isar TU München , Munich, Deutschland
  • Florian Ringel - Universitätsklinik Mainz , Klinikum rechts der Isar TU München , München, Deutschland
  • Jens Lehmberg - Klinikum rechts der Isar TU München , München, Deutschland
  • Bernhard Meyer - Klinikum rechts der Isar, Technische Universität München, Neurochirurgische Klinik und Poliklinik, München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocMO.15.03

doi: 10.3205/17dgnc086, urn:nbn:de:0183-17dgnc0860

Published: June 9, 2017

© 2017 Shiban et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: We investigated the hypothesis that many aseptic screw-loosening revisions in spinal instrumentations are in fact low-grade infections and not due to mechanical screw overload.

Methods: A prospective observational study was performed. All patients undergoing spinal instrumentation revision surgery between August 2015 and August 2016 were screened. In the study group all patients with an indication for revision due to screw loosening on CT-scan were included. In the control group those needing revision for adjacent disc disease were included. The rate of low-grade infection using a sonification fluid culture and routine swab culture were analyzed.

Results: 48 patients met all inclusion criteria. 44 patients were enrolled; thereby 24 (55%) cases and 20 (45%) cases were in the study and control groups, respectively. Median age was 70.6 years (range 40-83). 22 patients (46%) were male. Low-grade infections were identified in 42% and 20% of cases in the study and control group, respectively. All of those patients received postoperative antibiotic treatment.

Conclusion: Almost half of all patients presenting with symptomatic screw loosening following Instrumentation of the spine had a low-grade infection. The clinical relevance is still not clear, as 20% of the patients without screw loosening also had a low-grade infection.