Dynamic stabilization: a nidus for infection?. (4th March 2015)

• Record Type: Journal Article
• Authors: Goldstein, Ira M.; Agarwal, Nitin; Mammis, Antonios; Barrese, James C.; Christiano, Lana D.
• Is Part Of: International journal of neuroscience. Volume 125:Number 3(2015:Mar.)
• Page Start: 191
• Page End: 200
• Publication Date: 2015-03-04
• Subjects: Nervous system -- Periodicals; 612.805
• DOI: 10.3109/00207454.2014.908293
• Languages: English
• ISSNs: 0020-7454

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <p> <italic>Introduction</italic>: Dynamic stabilization offers an adjunct to fusion with motion preservation. In comparison, standard instrumented fusion (if) consists of titanium screws and rods/plates, which do not allow for motion at the level of the fusion. The reported infection rate following a standard if ranges from 0.2% to 7%. <italic>Methods</italic>: a retrospective chart review of 142 patients who underwent posterior lumbar stabilization procedures was conducted. Ten patients received dynamic stabilization and 132 patients had a standard if. Rates of infection, requiring hardware removal, were compared between the aforementioned groups. <italic>Results</italic>: Of the 132 patients undergoing posterior if, three developed a deep wound infection requiring removal of hardware (2.3%). Of the 10 patients undergoing dynamic stabilization, three developed a deep wound infection (30%) with 2 requiring removal of hardware (20%), secondary to persistent deep wound infection or osteomyelitis at the pedicle screw sites. There was a significantly increased risk of deep wound infection (<italic>p</italic> < 0.0001) with the use of dynamic stabilization compared to standard if. <italic>Conclusions</italic>: Our series demonstrates that the infection rate in patients undergoing dynamic stabilization is higher than the infection rate for instrumented fusion without a significant difference in comorbidity scores. We postulate that the polycarbonate urethane spacer acts as a medium for bacteria, whereas the titanium screws and rods are smooth, solid, and inert, resulting in a lower risk of infection.</p> </abstract>