Zygogiannis Konstantinos, Pappa Eleni, Antonopoulos Spyridon I, Tsalimas Georgios, Manolakos Konstantinos, Chatzikomninos Ioannis, Moschos Savvas, Thivaios Georgios C, Kalatzis Dimitrios, Kalampokis Anastasios
Trauma and Orthopaedics, Laiko General Hospital of Athens, Athens, GRC.
5th Orthopaedic Department, KAT General Hospital, Athens, GRC.
Cureus. 2023 Feb 1;15(2):e34494. doi: 10.7759/cureus.34494. eCollection 2023 Feb.
Background and objective ApiFix (OrthoPediatrics, Warsaw, IN) is an internal brace used for the correction of adolescent idiopathic scoliosis (AIS) classified as Lenke 1 or 5 with a Cobb angle of 35-60 degrees that decreases to ≤30 degrees on lateral side-bending radiographs. Since the indications are very specific, it is not a common procedure. Our study aimed to evaluate the incidence of surgical site infection (SSI) and its recurrence following treatment with ApiFix. Materials and methods A retrospective study of 44 cases of AIS treated at our center from 2016 to 2022 with ApifiX was conducted. Two patients who presented with SSI were initially treated with irrigation and debridement (I&D) following antibiotic therapy. Results A total of 44 patients with a mean age of 15.1 years were evaluated. Two of our patients presented with early-onset infection while one of them presented after the end of treatment with a skin ulcer due to septic screw loosening. The removal of the ApiFix implant revealed a pedicle abscess during the screw removal. Conclusions In this study of 44 patients, we observed two cases of infection and one case of reinfection. Given the limited muscle detachment and short operating time needed for Apifix, statistics suggest that the risk of SSI is always present. Further randomized trials are needed to gather more evidence on this subject.
背景与目的 ApiFix(美国印第安纳州华沙市的Orthopediatrics公司生产)是一种用于矫正青少年特发性脊柱侧凸(AIS)的内置支具,适用于Lenke 1型或5型、Cobb角为35 - 60度且在侧弯位X线片上角度减小至≤30度的情况。由于适应证非常特殊,这并非常见手术。我们的研究旨在评估使用ApiFix治疗后手术部位感染(SSI)的发生率及其复发情况。材料与方法 对2016年至2022年在我们中心接受ApiFix治疗的44例AIS患者进行回顾性研究。2例出现SSI的患者最初在抗生素治疗后接受了冲洗清创术(I&D)。结果 共评估了44例平均年龄为15.1岁的患者。我们的2例患者出现早期感染,其中1例在治疗结束后因螺钉松动导致皮肤溃疡。取出ApiFix植入物时发现螺钉取出过程中有椎弓根脓肿。结论 在这项对44例患者的研究中,我们观察到2例感染和1例再感染情况。鉴于ApiFix所需的肌肉分离有限且手术时间短,统计数据表明SSI风险始终存在。需要进一步的随机试验来收集关于这个问题的更多证据。