Do Sublaminar Polyester Bands Have an effect on the Outcomes of Postoperative Infections After Adolescent Idiopathic Scoliosis Surgical procedure?
J Pediatr Orthop. 2017 Dec;37(eight):e524-e529
Authors: Issa SP, Angelliaume A, Vidal C, Mazda Ok, Ilharreborde B
BACKGROUND: The incidence of surgical website infections (SSI) after adolescent idiopathic scoliosis (AIS) surgical procedure ranges from zero.5% to 7%. There’s at present a regain of curiosity in hybrid constructs, combining lumbar pedicle screws and thoracic sublaminar bands, however some authors have raised issues concerning the threat of SSI and the issue of bacterial eradication. The purpose of this research was subsequently to evaluate the outcomes of SSI after AIS surgical procedure utilizing sublaminar bands.
METHODS: A complete of 524 consecutive sufferers operated for AIS utilizing sublaminar bands between June 2006 and June 2014 have been included. SSI circumstances have been recognized and analyzed retrospectively. Radiologic and practical outcomes have been evaluated at follow-up utilizing EOS imaging and SRS 30 scores, and in contrast with a management group.
RESULTS: The general SSI charge was 5.three%, with a majority of monomicrobial (86%) infections occurring within the first 6 weeks postoperative (93%). Probably the most frequent pathogens have been pores and skin germs (Staphylococcus aureus and Propionibacterium acnes) with a group profile. Sufferers have been handled efficiently with surgical debridement with out implants removing, related to 6 weeks of antibiotherapy. Nevertheless, 25% of sufferers required >1 surgical debridement. Instrumentation removing was determined within the 2 circumstances with late SSI, and carried out uneventfully. Radiologic and practical outcomes at follow-up weren’t affected by the incidence of SSI.
CONCLUSIONS: Sublaminar bands aren’t related to a better threat of an infection. Nevertheless, the SSI charge within the present research stands within the higher vary of the literature, and different preventive methods ought to be thought of. In case of early an infection, bands removing will not be essential to acquire pathogen eradication, however the sublaminar implants will be pulled out safely in case of late SSI. The incidence of SSI doesn’t alter the outcomes at follow-up.
LEVEL OF EVIDENCE: Degree III.
PMID: 26866646 [PubMed – indexed for MEDLINE]