RESUMEN
STUDY DESIGN: A retrospective analysis of five cases of late spinal infection after spinal instrumentation and fusion. OBJECTIVES: These cases are reviewed to verify risk factors for late spinal infection after elective instrumentation and to manifest the treatment of this complication. SUMMARY OF LITERATURE REVIEW: Late spinal infection after elective spinal instrumentation and fusion are uncommon. The diagnosis is usually hard and requires much clinical suspicion. MATERIALS AND METHODS: 5 cases were in total 374 patients of the author's cases. These cases are reviewed retrospectively. RESULTS: All patients reported aggravated back pain. 4 patients had elevated erythrocyte sedimentation rates, averaging 44.8 mm/hour and elevated C-reactive protein, averaging 26.2mg/L. No distance foci of infection was identified. All patients got the radiolucent zone around screw fixation site, averaging 4.6mmwidth. The organisms were S. epidermidis in 1 case and coagulase(-) staphylococcus in 1 case. All cases were treated by operative method with debridement, instrument removal with or without revision and postoperative intravenous antibiotics. The average follow-up period was 18.2 months, one patient recurred back pain at 7 months after operation. CONCLUSION: The diagnosis of late infection after elective spinal instrumentation and fusion requires high suspicion of clinical symptoms and signs. All except one were successfully treated by operative treatment.