[Translated article] What's new in spinal instrumentation-related infections.

Infections associated with spinal instrumentation represent one of the most complex complications in spine surgery and frequently involve biofilm-forming pathogens that compromise the effectiveness of antimicrobial therapies. Diagnosis - particularly in chronic cases - requires the use of advanced microbiological techniques, such as implant sonication, next-generation metagenomic sequencing, and prolonged culture incubation. Therapeutic strategies depend on the chronicity of the infection and the stability of the implant, ranging from surgical debridement with retention of osteosynthesis material to staged delayed re-instrumentation. Empirical antibiotic therapy should be initiated promptly and subsequently adjusted according to microbiological results. Prevention remains a fundamental pillar and includes strict perioperative optimization. Favorable outcomes rely on early detection, a multidisciplinary team approach, and individualized surgical and antimicrobial management based on accurate clinical and radiological assessment.