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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_31_библиотеки_им_акад_М_И_Перельмана
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66 Postsurgical Spinal Infection
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Fig. 66.2 Deep postoperative infection in a patient with severe deformity. Throughout debridement and lavage. Skin closure
Table 66.1 Risk factors
Patient related
Older age Diabetes Prolonged
Obesity Urinary incontinence Prior infection Use of blood transfusion
Poor nutritional
status
Alcoholism >3 comorbid diseases Surgery after spine
Tobacco Tumor surgery
Comorbidities Past history
hospitalization
Complete neurological
decit
Prior spine surgery Prolonged surgical time
trauma
(resection)
Radiation therapy Fusion extending to the
Surgery related
Increased blood loss
Posterior approach >
anterior
Use of grafting and
instrumentation
sacrum
Spinal uid leak
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66.8 Potential Complications
Potential complications are pseudoarthrosis, chronic pain, adverse neurological
sequelae, return to the operating room, worsened long-term outcomes, and—in
most severe cases—even death; in case of deformity surgery, the removal of hardware may cause the recurrence of the deformity (if fusion has not occurred).
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A. Dimeglio and F. Canavese
66.9 What Should Patient andFamily Know?
Before each surgery, patients and their families must be informed of the infectious
risks, their treatment modality, and possibly short-, medium-, and long-term
complications.
Further Readings
Canavese F, Gupta S, Krajbich JI, Emara KM. Vacuum-assisted closure for deep infection after
spinal instrumentation for scoliosis. J Bone Joint Surg (Br). 2008;90(3):377–81.
Dowdell J, Brochin R, Kim J, Overley S, Oren J, Freedman B, etal. Postoperative spine infection:
diagnosis and management. Global Spine J. 2018;8(4S):37S–43S.
Pawar AY, Biswas SK.Postoperative spine infections. Asian Spine J. 2016;10:176–83.
Appendix A: Classication ofUpper
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Cervical Injuries
There have been many classication systems for different injury patterns. AO Spine
has introduced as part of the comprehensive classication system of all spine injuries a simple and unied classication of injuries to the region between occiput and
C2–C3 junction.
AO Spine Upper Cervical Classication System:
Three parts of this anatomical area:
1. Occipital condyle and occipitocervical junction
2. C1 ring and C1–C2 joint
3. C2 and C2–C3 joint
1.1 Occipital Condyle andOccipitocervical Junction
Type A: Simple or comminuted occipital condyle injuries
© The Author(s), under exclusive license to Springer Nature
Switzerland AG 2022
A. Şenköylü, F. Canavese (eds.), Essentials of Spıne Surgery,
https://doi.org/10.1007/978-3-030-80356-8
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Appendix A: Classication ofUpper Cervical Injuries
Type B: Nondisplaced ligamentary injury
Appendix A: Classication ofUpper Cervical Injuries
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Type C: OC dislocation
Appendix A: Classication ofUpper Cervical Injuries
Appendix A: Classication ofUpper Cervical Injuries
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1.2 C1 Ring andC1–C2 Joint
Type A: Isolated bony arch of C1:
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Appendix A: Classication ofUpper Cervical Injuries
Appendix A: Classication ofUpper Cervical Injuries
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Type B: With transverse atlantal ligament (TAL) injury
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Appendix A: Classication ofUpper Cervical Injuries
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