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Spine
Diagnosis
Spine Postprocedural Imaging
Postoperative Imaging and Complications
Postoperative Infection
Postoperative Infection
Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Definitions

            • Infectious sequelae following operative procedures

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Nonvascular Interventions

                      • Nuclear Medicine Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. El-Kadi M et al: Risk factors for postoperative spinal infection: a retrospective analysis of 5065 cases. Surg Neurol Int. 10:121, 2019
                                          2. Anderson PA et al: Prevention of surgical site infection in spine surgery. Neurosurgery. 80(3S):S114-23, 2017
                                          3. Babic M et al: Infections of the spine. Infect Dis Clin North Am. 31(2):279-97, 2017
                                          4. Chaichana KL et al: Risk of infection following posterior instrumented lumbar fusion for degenerative spine disease in 817 consecutive cases. J Neurosurg Spine. 20(1):45-52, 2014
                                          5. Mazzie JP et al: Imaging and management of postoperative spine infection. Neuroimaging Clin N Am. 24(2):365-74, 2014
                                          6. Master DL et al: Wound infections after surgery for neuromuscular scoliosis: risk factors and treatment outcomes. Spine (Phila Pa 1976). 36(3):E179-85, 2011
                                          7. Carragee E et al: Does acute placement of instrumentation in the treatment of vertebral osteomyelitis predispose to recurrent infection: long-term follow-up in immune-suppressed patients. Spine (Phila Pa 1976). 33(19):2089-93, 2008
                                          8. Solerio D et al: Successful surgical management of a delayed pharyngo-esophageal perforation after anterior cervical spine plating. Eur Spine J. 17 Suppl 2:S280-4, 2008
                                          9. Alpantaki K et al: Vertebral osteomyelitis, epidural and psoas abscess after epidural catheter use. Acta Orthop Belg. 73(5):670-3, 2007
                                          10. Katonis P et al: Postoperative infections of the thoracic and lumbar spine: a review of 18 cases. Clin Orthop Relat Res. 454:114-9, 2007
                                          11. Söyüncü Y et al: Posterior spinal epidural abscess: an unusual complication of vertebroplasty. Joint Bone Spine. 73(6):753-5, 2006
                                          12. Brown MD et al: A randomized study of closed wound suction drainage for extensive lumbar spine surgery. Spine. 29(10):1066-8, 2004
                                          13. De Winter F et al: 99mTc-ciprofloxacin planar and tomographic imaging for the diagnosis of infection in the postoperative spine: experience in 48 patients. Eur J Nucl Med Mol Imaging. 31(2):233-9, 2004
                                          14. Mastronardi L et al: Intraoperative antibiotic prophylaxis in clean spinal surgery: a retrospective analysis in a consecutive series of 973 cases. Surg Neurol. 61(2):129-35; discussion 135, 2004
                                          15. Mitra A et al: Treatment of massive thoracolumbar wounds and vertebral osteomyelitis following scoliosis surgery. Plast Reconstr Surg. 113(1):206-13, 2004
                                          16. Bavinzski G et al: Microsurgical management of postoperative disc space infection. Neurosurg Rev. 26(2):102-7, 2003
                                          17. Bose B: Delayed infection after instrumented spine surgery: case reports and review of the literature. Spine J. 3(5):394-9, 2003
                                          18. Carreon LY et al: Perioperative complications of posterior lumbar decompression and arthrodesis in older adults. J Bone Joint Surg Am. 85-A(11):2089-92, 2003
                                          19. De Winter F et al: 18-fluorine fluorodeoxyglucose positron emission tomography for the diagnosis of infection in the postoperative spine. Spine. 28(12):1314-9, 2003
                                          20. Olsen MA et al: Risk factors for surgical site infection in spinal surgery. J Neurosurg. 98(2 Suppl):149-55, 2003
                                          21. Schnoring M et al: Prophylactic antibiotics in lumbar disc surgery: analysis of 1,030 procedures. Zentralbl Neurochir. 64(1):24-9, 2003
                                          22. Ross JS et al: The postoperative lumbar spine: enhanced MR evaluation of the intervertebral disk. AJNR Am J Neuroradiol. 17(2):323-31, 1996
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Clinical Issues

                                                  TERMINOLOGY

                                                  • Definitions

                                                    • Infectious sequelae following operative procedures

                                                  IMAGING

                                                  • General Features

                                                    • Radiographic Findings

                                                      • CT Findings

                                                        • MR Findings

                                                          • Ultrasonographic Findings

                                                            • Nonvascular Interventions

                                                              • Nuclear Medicine Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. El-Kadi M et al: Risk factors for postoperative spinal infection: a retrospective analysis of 5065 cases. Surg Neurol Int. 10:121, 2019
                                                                                  2. Anderson PA et al: Prevention of surgical site infection in spine surgery. Neurosurgery. 80(3S):S114-23, 2017
                                                                                  3. Babic M et al: Infections of the spine. Infect Dis Clin North Am. 31(2):279-97, 2017
                                                                                  4. Chaichana KL et al: Risk of infection following posterior instrumented lumbar fusion for degenerative spine disease in 817 consecutive cases. J Neurosurg Spine. 20(1):45-52, 2014
                                                                                  5. Mazzie JP et al: Imaging and management of postoperative spine infection. Neuroimaging Clin N Am. 24(2):365-74, 2014
                                                                                  6. Master DL et al: Wound infections after surgery for neuromuscular scoliosis: risk factors and treatment outcomes. Spine (Phila Pa 1976). 36(3):E179-85, 2011
                                                                                  7. Carragee E et al: Does acute placement of instrumentation in the treatment of vertebral osteomyelitis predispose to recurrent infection: long-term follow-up in immune-suppressed patients. Spine (Phila Pa 1976). 33(19):2089-93, 2008
                                                                                  8. Solerio D et al: Successful surgical management of a delayed pharyngo-esophageal perforation after anterior cervical spine plating. Eur Spine J. 17 Suppl 2:S280-4, 2008
                                                                                  9. Alpantaki K et al: Vertebral osteomyelitis, epidural and psoas abscess after epidural catheter use. Acta Orthop Belg. 73(5):670-3, 2007
                                                                                  10. Katonis P et al: Postoperative infections of the thoracic and lumbar spine: a review of 18 cases. Clin Orthop Relat Res. 454:114-9, 2007
                                                                                  11. Söyüncü Y et al: Posterior spinal epidural abscess: an unusual complication of vertebroplasty. Joint Bone Spine. 73(6):753-5, 2006
                                                                                  12. Brown MD et al: A randomized study of closed wound suction drainage for extensive lumbar spine surgery. Spine. 29(10):1066-8, 2004
                                                                                  13. De Winter F et al: 99mTc-ciprofloxacin planar and tomographic imaging for the diagnosis of infection in the postoperative spine: experience in 48 patients. Eur J Nucl Med Mol Imaging. 31(2):233-9, 2004
                                                                                  14. Mastronardi L et al: Intraoperative antibiotic prophylaxis in clean spinal surgery: a retrospective analysis in a consecutive series of 973 cases. Surg Neurol. 61(2):129-35; discussion 135, 2004
                                                                                  15. Mitra A et al: Treatment of massive thoracolumbar wounds and vertebral osteomyelitis following scoliosis surgery. Plast Reconstr Surg. 113(1):206-13, 2004
                                                                                  16. Bavinzski G et al: Microsurgical management of postoperative disc space infection. Neurosurg Rev. 26(2):102-7, 2003
                                                                                  17. Bose B: Delayed infection after instrumented spine surgery: case reports and review of the literature. Spine J. 3(5):394-9, 2003
                                                                                  18. Carreon LY et al: Perioperative complications of posterior lumbar decompression and arthrodesis in older adults. J Bone Joint Surg Am. 85-A(11):2089-92, 2003
                                                                                  19. De Winter F et al: 18-fluorine fluorodeoxyglucose positron emission tomography for the diagnosis of infection in the postoperative spine. Spine. 28(12):1314-9, 2003
                                                                                  20. Olsen MA et al: Risk factors for surgical site infection in spinal surgery. J Neurosurg. 98(2 Suppl):149-55, 2003
                                                                                  21. Schnoring M et al: Prophylactic antibiotics in lumbar disc surgery: analysis of 1,030 procedures. Zentralbl Neurochir. 64(1):24-9, 2003
                                                                                  22. Ross JS et al: The postoperative lumbar spine: enhanced MR evaluation of the intervertebral disk. AJNR Am J Neuroradiol. 17(2):323-31, 1996