The Johns Hopkins Medical Institutions, 601 North Caroline St #5212, Baltimore, MD 21287-0882, USA.
Clin Orthop Relat Res. 2010 Mar;468(3):711-6. doi: 10.1007/s11999-009-0933-4. Epub 2009 Jun 19.
Infection is a serious complication of surgery to correct scoliosis in patients with cerebral palsy (CP). We obtained multicenter representative figures for deep and superficial infection rates, analyzed risk factors and treatment outcomes, and compared deformity correction relative to infection. We retrospectively reviewed 157 patients who had posterior spinal fusion for CP at one of eight centers. Preoperative and intraoperative variables were subjected to multivariate analysis to determine factors predictive of infection. There were 16 wound infections (10%; nine deep, seven superficial). Only two study factors predicted infection: higher preoperative white blood cell count (8.5 versus 6.4 [in those without infection] x 10(3)) and use of a unit rod (15% versus 5% for bent rods). Fourteen patients underwent irrigation and débridement procedures. Five infections required 2 months or longer to resolve. Two had implant removal. Final curve correction was lower for those with deep infections than those without (67% versus 53%, respectively). We noted a trend toward greater percentages of pain at last followup in those with deep infection than in those without infection (50% versus 18%, respectively) but the study was not adequately powered to confirm this point. Our infection rate in scoliosis surgery for CP was higher than that for most elective spinal deformity surgery.
Level III, retrospective case-control study. See Guidelines for Authors for a complete description of levels of evidence.
在脑瘫（CP）患者接受脊柱侧弯矫正手术时，感染是一种严重的并发症。我们获得了多中心有代表性的深部和浅部感染率数据，分析了危险因素和治疗结果，并比较了与感染相关的畸形矫正情况。我们回顾性分析了在 8 家中心之一接受后路脊柱融合术的 157 例 CP 患者。对术前和术中的变量进行多变量分析，以确定感染的预测因素。共有 16 例伤口感染（10%；9 例深部感染，7 例浅部感染）。只有两个研究因素预测感染：较高的术前白细胞计数（8.5 与 6.4[无感染组]x10(3)）和使用单元棒（15%与 5%弯曲棒）。14 例患者行灌洗清创术。5 例感染需要 2 个月或更长时间才能解决。2 例患者行植入物取出术。深部感染患者的最终曲线矫正较无深部感染患者低（分别为 67%和 53%）。我们注意到，深部感染患者的最后随访时疼痛百分比高于无深部感染患者（分别为 50%和 18%），但该研究的效力不足以证实这一点。我们 CP 脊柱侧弯矫正手术的感染率高于大多数择期脊柱畸形手术。
III 级，回顾性病例对照研究。有关证据等级的完整描述，请参见作者指南。
