Implant Microbial Colonization Detected by Sonication as a Cause for Spinal Device Failure: A Prospective Study

• Published in: Spine (Philadelphia, Pa. 1976) Pa. 1976), 2021-11, Vol.46 (21), p.1485-1494
• Main Authors: García-Pérez, Daniel, Lagares, Alfonso, Castaño-León, Ana María, Panero, Irene, Munarriz, Pablo M., Delgado-Fernández, Juan, Jiménez-Roldán, Luis, Pérez-Núñez, Angel, Alén, Jose Antonio F., Paredes, Igor
• Format: Article
• Language: English
• ISSN: 0362-2436; 1528-1159
• DOI: 10.1097/BRS.0000000000004063

STUDY DESIGNA prospective single center observational study. OBJECTIVESThe aim of this study was to examine the potential role of sonication in the diagnosis of low-grade infections and its association with pedicle screw (PS) loosening, and to describe risk factors and radiological findings associated with spinal implant infection. SUMMARY OF BACKGROUND DATAAlthough PS loosening has mainly been attributed to mechanical overload, implant colonization and biofilm formation have recently been suggested. Culturing of sonication fluid implants is promising in the field of spine instrumentation infection, but little data are available. METHODSWe prospectively included all patients who were subjected to implant removal. PS loosening was assessed with computed tomography (CT) scan. Different clinical and radiological parameters which could serve as indicators of implant infection were studied. RESULTSThirty-eight patients were included in the study and 11 of them (29%) had a positive sonication result. Patients with spinal implant infection were associated with screw loosening (P = 0.005). Particularly, those screws with a positive microbiological culture showed signs of screw loosening in the preoperative CT scan (P