Treatment of postoperative acute infection after internal fixation for patients with lower lumbar vertebral diseases by transpedicular screw system

Objective To determine the best therapeutic strategy in the treatment of postoperative acute infection surgical procedures after internal fixation for patients with lower lumbar vertebral diseases by transpedicular screw system.Methods Surgical procedures for 22 patients(9 males and 13 females) with postoperative acute infection were analyzed retrospectively,who underwent internal fixtion by transpedicular screw system to treat lower lumbar vertebral diseases from January 1995 to December 2009.The average age of the patients was 53.8 years(37-68 years).Postoperative acute infections occurred at 5-21 d after internal fixation.After final diagnosis,18 cases underwent surgical procedures(2 case with debridement and removal of internal fixators,16 cases with debridement only),while 4 cases underwent non-surgical management.Results In the patients that underwent surgical procedures,2 cases treated by debridement and removal of implants were healed at the first stage;in the other patients with debridement only,13 cases were healed at the first stage,and 3 case that didn't got primary healing recovered after another debridement and removal of the implants.In patients with non-surgical management,1 case recovered and the other 3 cases recovered after debridement and removal of the implants.All patient were followed up with a mean pieriod of 27.5 months(8-60 moths),and no infection occurred again.Fusion were obtained in 18 cases at 4-6 months after operation.Conclusion Once acute infection occur after internal fixation by transpedicular screw system,surgical procedures should be performed in time,and removal of implants can be accepted if necessary.