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Effect of deep wound infection following lumbar arthrodesis for degenerative disc disease on long-term outcome: a prospective study: clinical article

OBJECT: Deep wound infections are one of the most common and serious complications of spinal surgery. The impact of such infections on long-term outcomes is not well understood. The purpose of this study was to evaluate the functional status and satisfaction in patients who suffered a deep wound infection after undergoing lumbar arthrodesis for symptomatic degenerative disc disease. METHODS: The authors conducted a prospective study in 13 patients with a clinical and radiological diagnosis of symptomatic degenerative lumbar stenosis and instability; after undergoing decompression and instrumentation-augmented arthrodesis, the patients suffered a deep wound infection (infection group). A 3:1 (39-patient) matched cohort was selected for comparison (control group). All surgeries were performed during the same period and by a single surgeon. The postoperative infections were all treated in a similar manner and the instrumentation was not removed. Both groups were followed up and assessed with validated outcome instruments: Numerical Rating Scale of pain, Oswestry Disability Index, 36-Item Short Form Health Survey, Beck Depression Inventory, and Hospital Anxiety and Depression Scale. Patient satisfaction was also determined. RESULTS: The median follow-up duration was 22 months (range 6-108 months). The mean patient age was 62 +/- 10 years, and 59.6% of the patients were female. There was no significant difference between the groups in pain, functional disability, quality of life, or depression and anxiety. However, 53.8% of the patients with infection were not satisfied with the procedure at the final evaluation, compared with 15.4% of the patients without a deep wound infection (p = 0.003). CONCLUSIONS: Patients with successfully treated postoperative deep wound infections do not have a difference in functional outcome compared with patients who underwent an identical operation but did not suffer a complicating infection. Patients who suffered an infection were more likely to be unsatisfied with the procedure than patients who did not

Keywords : adverse effects,Aged,Anti-Bacterial Agents,Anxiety,Arthrodesis,complications,Debridement,diagnosis,drug therapy,Female,Follow-Up Studies,Humans,Infection,instrumentation,Intervertebral Disc Degeneration,Lumbar Vertebrae,Male,methods,Middle Aged,Neurosurgery,Pain,Patient Satisfaction,Prospective Studies,Quality of Life,Spinal Fusion,surgery,Surgical Wound Infection,therapeutic use,Treatment Outcome,Wound Infection,, Deep,Wound,Infection,Following, persistent idiopathic facial pain

Date of Publication : 2011 Oct

Authors : Falavigna A;Righesso O;Traynelis VC;Teles AR;da Silva PG;

Organisation : Department of Neurosurgery, University of Caxias do Sul, Rio Grande do Sul, Brazil. asdrubalmd@gmail.com

Journal of Publication : J Neurosurg Spine

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/21682558

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