It is a prospective single-center observational study. For a study, the researchers wanted to determine the function of sonication in the detection of low-grade infections and its link to pedicle screw (PS) loosening, as well as to describe risk variables and radiological abnormalities linked to spinal implant infection. Although mechanical pressure has been the primary cause of PS loosening, implant colonization, and biofilm growth have lately been hypothesized. In the realm of spine instrumentation infection, culturing of sonication fluid implants is promising; however, there is little data. All patients who had implants removed were included in the outline prospectively. A computed tomography (CT) scan was used to assess PS loosening. The researchers looked at various clinical and radiological markers that could be used as indicators of implant infection. The research included 38 individuals, with 11 (29%) having a favorable sonication outcome. Screw loosening was linked to patients with spinal implant infection (P=0.005). In the preoperative CT scan, those screws with a positive microbiological culture revealed evidence of screw loosening (P<0.001). Radiological screw loosening at the L1-L3 level, as well as loosened more giant constructs, were also linked to screw microbial colonization, according to the researchers. Coagulase-negative staphylococci and Cutibacterium acnes were the most commonly isolated bacteria. Screw loosening, the absence of prophylactic cefazolin, ICU hospitalization, screw breakage, and L1-L3 spine level were all found to be independent risk factors for implant-associated infection in an implant-based multivariate analysis. With an area under the curve of 0.937, the model had a solid predictive capability. Because the clinical presentation of deep implant chronic infection is unspecific, taking these characteristics into account allows for preoperative implant colonization prediction and risk stratification, which aids patient treatment.
Link:journals.lww.com/spinejournal/Abstract/2021/11010/Implant_Microbial_Colonization_Detected_by.14.aspx
