Iatrogenic Spinal Infection after Injection Therapy in Spine / 대한척추외과학회지

ABSTRACT

STUDY DESIGNS A retrospective study of clinical experience. OBJECTIVES: To investigate and report the iatrogenic form of spinal infections that occur after injection therapy in the spine. SUMMARY OF LITERATURE REVIEW An iatrogenic infection after injection therapy in the spine is rarely reported to be a serious complication. However, an increase in the number of immunocompromised patients, the aging of the population, and particularly an increase in spinal procedureshave precipitated a rise in the incidence of spinal infections. MATERIALS AND METHOD: Iatrogenic spinal infections occurred in 8 patients after various injection therapy in the spine, which included an epidural steroid injection or trigger point injection for various spinal conditions. The medical records and images of these patients regarding the clinical findings, risk factors, and treatments were analyzed. RESULTS: The pathologic conditions of the spinal infection were discitis in four patients with a concomitant infection in the epidural space and paraspinal muscles, an epidural abscess, and solitary muscular abscess or myositis in the other 3 patients. The systemic risk factors contributing to the infections were diabetes mellitus, metastatic cancer, and chronic liver disease in four patients. For treatment, intensive antibiotic therapy was applied to all patients. Six of the 8 patients underwent surgical drainage for abscesses and/or fusion to stabilize the infected segments. The infections were eventually controlled in all patients. CONCLUSION: Iatrogenic pyogenic infections of the spine after injection therapy in the spine is a serious complication with regard morbidity and treatment. To avoid these serious complications, a specialist experienced in aseptic techniques should perform these spinal procedures, particularly in those patients with the risk factors.