Implant-Associated Spinal Infections in Children: How Can We Improve Diagnosis and Management?

Jason Lake; Oren Gordon

doi:10.1016/j.idc.2021.11.005

Implant-Associated Spinal Infections in Children: How Can We Improve Diagnosis and Management?

Infect Dis Clin North Am. 2022 Mar;36(1):101-123. doi: 10.1016/j.idc.2021.11.005.

Authors

Jason Lake¹, Oren Gordon²

Affiliations

¹ Division of Infectious Diseases, Department of Pediatrics, University of Utah School of Medicine, 295 Chipeta Way, Salt Lake City, UT 84132, USA. Electronic address: jason.lake@hsc.utah.edu.
² Division of Infectious Diseases, Department of Pediatrics, Johns Hopkins University School of Medicine, 200 N. Wolfe Street, Baltimore, MD 21287, USA.

PMID: 35168705
DOI: 10.1016/j.idc.2021.11.005

Abstract

Implant-associated spinal infection affects up to 10% of all pediatric instrumented spinal fixation surgeries and is associated with patient morbidity and significant impact on the health care system. Children with neuromuscular scoliosis are at increased risk compared with those with idiopathic scoliosis. Early infections (≤90 days from index surgery) are caused by virulent pathogens such as Staphylococcus aureus; more indolent pathogens cause late infections. Early infections are treated with debridement and implant retention with prolonged antibiotics, but implant removal is often needed to treat late infections. Antibiofilm agents and pathogen-specific imaging may improve future outcomes.

Keywords: Biofilm; Implant; Scoliosis; Spine surgery; Surgical site infection.

Publication types

Review

MeSH terms

Child
Humans
Neurosurgical Procedures
Postoperative Complications
Scoliosis* / diagnosis
Scoliosis* / therapy
Staphylococcal Infections* / diagnosis
Staphylococcal Infections* / drug therapy
Staphylococcus aureus