Spinal Implants Can Be Retained in Patients with Deep Spine Infection: A Cohort Study: 深層脊椎感染的患者可以保留脊柱植入物 - 一項隊列研究

Abstract 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.