[Surgical treatment of deep infection around the spine].

OBJECTIVE

To study the surgical method and clinical effect of deep infection around the spine.

METHODS

The clinical data of 7 patients with deep infections around the spine treated from January 2015 to January 2018 were retrospectively analyzed. All patients were acute infection within 3 weeks after spinal surgery. There were 5 males and 2 females, aged from 29 to 67 years old with an average of 42 years old. Four of them had implants and the other three didn't. After infection was diagnosed, they accepted aggressive debridement with assistance of vacuum sealing drainage(VSD). The antibiotic artificial bones were put in wounds, combined with intravenous antibiotics. Blood-rich adjacent tissue flaps were used to reconstruct defect of wounds. The tissue flaps included 4 paraspinal muscle flaps, 1 thoracolumbar fascial flap, 1 latissimus dorsi flap and 1 paraspinal muscle combined with thoracolumbar fascial flap.

RESULTS

All 7 patients were followed up from 6 to 24 months with an average of 13.28 months. During the follow-up period, among the 4 patients with instrument, except one patient of lumbar fusion removed internal fixation due to postoperative infection, the other 3 patients successfully kept the implants. One case of cervical fracture and dislocation was repaired by latissimus dorsi transposition. Its wound healed but hydrops accumulated under the flap. This patient was cured by puncture drainage and local pressure bandaging. The other 5 wounds' healing were first intention and no postoperative complications such as infection recurrence, hematoma, effusion or wound dehiscence occurred.

CONCLUSIONS

Deep infection around the spine is a serious complication and should be treated aggressively once diagnosed. Thorough debridement with the help of negative pressure closed drainage, local application of antibiotic artificial bone combined with systemic intravenous antibiotics and repairing wounds with adjacent tissue flaps are effective procedures for the treatment of deep infection around the spine.