Department of Spine Surgery, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Orthopedics, Southwest Hospital, Army (Third) Military Medical University, Chongqing, China.
Pain Res Manag. 2021 Oct 7;2021:2262837. doi: 10.1155/2021/2262837. eCollection 2021.
To research the incidence of surgical site infection (SSI) following lumbar Dynesys dynamic internal fixation and its management strategy.
We retrospectively analyzed all cases of lumbar Dynesys dynamic internal fixation performed from January 2010 to December 2019, and the data from patients with SSI were collected. The observational indicators included the incidence of SSI, general information of the patients, surgical details, inflammatory indicators, pathogenic bacteria, and treatment. SSI was defined as both early infection and delayed infection, and the cases were divided into Groups A and B, respectively. The relevant indicators and treatment were compared between the two groups.
A total of 1125 cases of lumbar Dynesys dynamic internal fixation were followed up. Twenty-five cases of SSI occurred, and the incidence of SSI was 2.22% (25/1125). There were 14 cases of early infection (1.24%) and 11 cases of delayed infection (0.98%). Fourteen cases of early infection occurred 12.3 ± 8.3 days postoperatively (3-30), and 11 cases of delayed infection occurred 33.3 ± 18.9 months postoperatively (3-62). The inflammatory indicators of Group A were significantly higher than those of Group B (all < 0.05), except for procalcitonin. The main infection site in Group A was located on the skin and subcutaneous tissue and around the internal instrument, while the main infection site in Group B was around the internal instrument. The main treatment for Group A was debridement and implant replacement, and the main treatment for Group B was implant removal. . The incidence of SSI following lumbar Dynesys dynamic internal fixation was 2.22%, the incidence of early SSI was 1.24%, and the incidence of delayed SSI was 0.98%. If the main infection site of early infection is in the incision, debridement should be the main treatment method; if the infection site is around the internal fixation, implant replacement is recommended on the basis of debridement. Once delayed infection is diagnosed, implant removal is suggested.
研究腰椎动态内固定 Dynesys 术后手术部位感染（SSI）的发生率及其处理策略。
回顾性分析 2010 年 1 月至 2019 年 12 月行腰椎 Dynesys 动态内固定的所有病例，收集 SSI 患者资料。观察指标包括 SSI 发生率、患者一般资料、手术细节、炎症指标、病原菌及治疗情况。SSI 定义为早期感染和延迟感染，将病例分为 A、B 两组，分别比较两组的相关指标和治疗情况。
共随访腰椎 Dynesys 动态内固定 1125 例，发生 SSI 25 例，SSI 发生率为 2.22%（25/1125）。其中早期感染 14 例（1.24%），延迟感染 11 例（0.98%）。早期感染 14 例发生于术后 12.3±8.3d（3-30d），延迟感染 11 例发生于术后 33.3±18.9 个月（3-62 个月）。A 组炎症指标显著高于 B 组（均 <0.05），降钙素原除外。A 组感染部位主要位于皮肤及皮下组织和内置物周围，B 组主要感染部位位于内置物周围。A 组主要治疗方法为清创+内固定物更换，B 组主要治疗方法为取出内固定物。
腰椎 Dynesys 动态内固定术后 SSI 发生率为 2.22%，早期 SSI 发生率为 1.24%，延迟 SSI 发生率为 0.98%。早期感染若主要感染部位在切口，以清创为主；若感染部位在内置物周围，在清创基础上建议更换内固定物。一旦诊断为延迟感染，建议取出内固定物。
