Effect of deep wound infection following lumbar arthrodesis for degenerative disc disease on long-term outcome: a prospective study

Clinical article

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Object

Deep wound infections are one of the most common and serious complications of spinal surgery. The impact of such infections on long-term outcomes is not well understood. The purpose of this study was to evaluate the functional status and satisfaction in patients who suffered a deep wound infection after undergoing lumbar arthrodesis for symptomatic degenerative disc disease.

Methods

The authors conducted a prospective study in 13 patients with a clinical and radiological diagnosis of symptomatic degenerative lumbar stenosis and instability; after undergoing decompression and instrumentation-augmented arthrodesis, the patients suffered a deep wound infection (infection group). A 3:1 (39-patient) matched cohort was selected for comparison (control group). All surgeries were performed during the same period and by a single surgeon. The postoperative infections were all treated in a similar manner and the instrumentation was not removed. Both groups were followed up and assessed with validated outcome instruments: Numerical Rating Scale of pain, Oswestry Disability Index, 36-Item Short Form Health Survey, Beck Depression Inventory, and Hospital Anxiety and Depression Scale. Patient satisfaction was also determined.

Results

The median follow-up duration was 22 months (range 6–108 months). The mean patient age was 62 ± 10 years, and 59.6% of the patients were female. There was no significant difference between the groups in pain, functional disability, quality of life, or depression and anxiety. However, 53.8% of the patients with infection were not satisfied with the procedure at the final evaluation, compared with 15.4% of the patients without a deep wound infection (p = 0.003).

Conclusions

Patients with successfully treated postoperative deep wound infections do not have a difference in functional outcome compared with patients who underwent an identical operation but did not suffer a complicating infection. Patients who suffered an infection were more likely to be unsatisfied with the procedure than patients who did not.

Abbreviations used in this paper: BDI = Beck Depression Inventory; HADS = Hospital Anxiety and Depression Scale; NRS = Numerical Rating Scale; ODI = Oswestry Disability Index; SF-36 = 36-Item Short Form Health Survey.

Article Information

Address correspondence to: Asdrubal Falavigna, M.D., Ph.D., Coordinator of the Medical Faculty of the University of Caxias do Sul, Rua General Arcy da Rocha Nóbrega, 401/602, Caxias do Sul, Rio Grande do Sul, Brazil 95040-290. email: asdrubalmd@gmail.com.

Please include this information when citing this paper: published online June 17, 2011; DOI: 10.3171/2011.5.SPINE10825.

© AANS, except where prohibited by US copyright law.

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