Karczewski Daniel, Pumberger Matthias, Müller Michael, Andronic Octavian, Perka Carsten, Winkler Tobias
Center for Musculoskeletal Surgery, Charité - Universitaetsmedizin Berlin, Berlin, Germany.
Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
J Spine Surg. 2020 Dec;6(4):800-813. doi: 10.21037/jss-20-12.
Both, periprosthetic joint infection (PJI) and peri-spinal implant infection (PSII) are serious complications occurring in arthroplasty and spine instrumentation with absolute numbers expected to rise in the next years. The currently existing literature data describing the characteristics of PSII are limited when compared to PJI studies. However, both PJI and PSII exhibit similarities concerning pathogenesis, symptoms, diagnosis, treatment and prognosis. This literature review aims at comparing PJI and PSII and to develop implications for diagnosis and treatment of PSII from existing studies about PJI. The review was performed on the basis of a structured PubMed, Cochrane Library, and Medline analysis and existing guidelines, with 99 references being included. The results indicate that specific terms like re-infection should be defined in the context of PSII based on existing definitions of PJI, that biofilm studies and studies analyzing different prosthesis surfaces in arthroplasty could be used for PSII, and that histopathology as an additional standard tool in PSII diagnosis might be helpful. In addition, the development of a standardized algorithm-based treatment system with antibiotic protocols, including long term suppression, for PSII similar to the ones existing for PJI is necessary.
人工关节周围感染(PJI)和脊柱植入物周围感染(PSII)都是关节置换术和脊柱内固定术中出现的严重并发症,预计未来几年其绝对病例数将会增加。与PJI研究相比,目前描述PSII特征的文献数据有限。然而,PJI和PSII在发病机制、症状、诊断、治疗和预后方面存在相似之处。这篇文献综述旨在比较PJI和PSII,并根据现有的PJI研究对PSII的诊断和治疗提出启示。该综述基于结构化的PubMed、Cochrane图书馆和Medline分析以及现有指南进行,共纳入99篇参考文献。结果表明,应根据现有的PJI定义在PSII背景下定义诸如再感染等特定术语,关节置换术中的生物膜研究和分析不同假体表面的研究可用于PSII,并且组织病理学作为PSII诊断中的一种额外标准工具可能会有所帮助。此外,有必要开发一种基于标准化算法的治疗系统,该系统具有类似于PJI现有抗生素方案的PSII抗生素方案,包括长期抑制。
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