Management of Delayed Infection after Spinal Internal Fixation by Pedicle of Vertebral Arch Screw

Objective:To improve the treatment of delayed infection after spinal internal fixation by pedicle of vertebral arch screw. Methods:Twenty-six patients were affected by delayed infection after spinal internal fixation by pedicle of vertebral arch screw.A11 patients underwent debridement and 1avage.Among them,internal fixator were removed in 20 and kept in place in 6 as a result of reduction and antibiotics lavage.Antibiotics were administrated intravenously in all patients for about l4 to 21 days after operation. Results:After debridement and internal fixator removal,20 patients.ESR and CRP were decreased to normal status.One other patients had painful focus with swelling and hard lump 1 month after initial debridement,internal fixator removal and lavage,also antibiotics were used intravenously,3 weeks after surgery,the patient discharged with wound healing and swelling disappearing.All patients were followed up for 12～25 months and no complication was recorded.Conclusion:Delayed infections may be caused by contaminations during initial operation.If diagnosis confirmed,operative procedure should be carried out.The surgical procedures should include debridement,internal fixator removal,lavage and antibiotics administration.