Postoperative Spinal Wound Infection in Neurosurgical wards at RIMS, a Single Centre Experience
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 17, Issue 2
Abstract
With modern surgical techniques and perioperative antibiotics, spinal infection after surgery is relatively uncommon. Certain patient and surgical treatments are however at higher risk and should be treated with extra caution. Surgical site infection (SSI) following spine surgery is a dreaded complication with significant morbidity and economic burden. SSIs following spine surgery can be superficial, characterized by obvious wound drainage or deep-seated with a healed wound. Staphylococcus aureus remains the principal causal agent. There are certain pre-operative risk factors that increase the risk of SSI, mainly diabetes, smoking, steroids, and peri-operative transfusions. Additionally, intra-operative risk factors include surgical invasiveness, type of fusion, implant use, and traditional instead of minimally invasive approach. A high level of suspicion is crucial to attaining an early definitive diagnosis and initiating appropriate management. The most common presenting symptom is back pain, usually manifesting 2–4 weeks and up to 3 months after a spinal procedure. Scheduling a follow-up visit between weeks 2 and 4 after surgery is therefore necessary for early detection. Inflammatory markers are important diagnostic tools, and comparing pre-operative with postoperative levels should be done when suspecting SSIs following spine surgery. Magnetic resonance imaging remains the diagnostic modality of choice when suspecting a SSI following spine surgery.
Authors and Affiliations
Dr Alok Chandra Prakash, Dr Anand Prakash, Dr Chandra Bhushan Sahay
Keywords
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- EP ID EP361455
- DOI 10.9790/0853-1702042024
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