Significance of XXXX -positive samples in spinal instrumentation.

@entity1 @entity1851 @entity295 @entity5478
STUDY DESIGN: A retrospective study about @entity5478 infections after Cotrel-Dubousset (CD) instrumentation. OBJECTIVES: To analyze the significance of @entity5478 -positive deep samples after CD. SUMMARY OF BACKGROUND DATA: The diagnosis of spinal infections to @entity5478 after CD is difficult. METHODS: @entity1 with revision surgery and at least 1 @entity5478 -positive deep sample, between 2000 and 2006 were included. Group A had 1 revision surgery and group B had 2 successive revision surgeries, with @entity5478 -positive deep samples. Group A was divided into 2 subgroups according to the peroperative macroscopic aspect, subgroup A1 with septic tissues, subgroup A2 without septic tissues. The biologic characteristics of the @entity1 and the surgical and medical treatments were assessed. RESULTS: Sixty-eight @entity1 were included, 60 in group A (A1 = 33, A2 = 27) and 8 in group B. Group A: 26 @entity1 had 1 or 2 @entity5478 -positive samples and 34 had at least 3 @entity5478 -positive samples. Histology showed chronic inflammatory changes. @entity1851 value median rate was 42 (A1) and 5 mg/L (A2). Twenty-two @entity1 had a complete implant removal (14 with antibiotics, A1 = 12, A2 = 2). Nine @entity1 had a total implant replacement (7 with antibiotics). Twenty-two @entity1 had a partial implant removal (17 with antibiotics, A1 = 5, A2 = 12). Seven A1 @entity1 had an irrigation and debridement (6 with antibiotics). The evolution was favorable for 28 @entity1 . Seven @entity1 had a documented @entity295 . Group B: during the first revision, 8 @entity1 had a partial implant removal (2 with antibiotics); during the second revision, all patients received antibiotics 4 of whom had a total implant removal. The long-term evolution was favorable for 6 @entity1 . CONCLUSION: @entity5478 infection of spinal instrumentation is difficult to diagnose. Results of at least 4 deep sample cultures, histology, and @entity1851 values must be compared to the peroperative macroscopic aspect.
