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Implant microbial colonization detected by sonication as a cause for spinal device failure

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dc.contributor.authorGarcía Pérez, Daniel
dc.contributor.authorLagares, Alfonso
dc.contributor.authorCastaño León, Ana María
dc.contributor.authorPanero, Irene
dc.contributor.authorMunarriz, Pablo M.
dc.contributor.authorDelgado Fernández, Juan
dc.contributor.authorJiménez Roldán, Luis
dc.contributor.authorPérez-Núñez, Ángel
dc.contributor.authorAlén, Jose Antonio F.
dc.contributor.authorParedes, Igor
dc.contributor.departmentFarmacología
dc.date.accessioned2026-02-26T13:05:41Z
dc.date.available2026-02-26T13:05:41Z
dc.date.copyright© 2021 Wolters Kluwer Health, Inc.
dc.date.issued2021-11-01
dc.description.abstractStudy Design. A prospective single center observational study. Objectives. The 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 Data. Although 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. Methods. We 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. Results. Thirty-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 < 0.001). Our results also showed that radiological screw loosening at L1-L3 level, and loosened larger constructs were associated with screw microbial colonization. The most common isolated microorganisms were coagulase-negative staphylococci and Cutibacterium acnes. An implant-based multivariate analysis indicated that screw loosening, the absence of prophylactic cefazolin, ICU hospitalization, screw breakage, and L1-L3 spine level were independent risk factors for implant-associated infection. Our model exhibited a high predictive power with an area under the curve of 0.937. Conclusion. As clinical presentation of deep implant chronic infection is unspecific, consideration of these factors enables preoperative prediction and risk stratification of implant colonization, thus helping patient's management. Level of Evidence: 3
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dc.identifier.citationSpine, 46(21):p 1485-1494, November 01, 2021
dc.identifier.doihttps://doi.org/10.1097/BRS.0000000000004063
dc.identifier.eissn1528-1159
dc.identifier.issn0362-2436
dc.identifier.urihttp://hdl.handle.net/10201/214741
dc.languageeng
dc.publisherLippincott, Williams & Wilkins
dc.relationSin financiación externa a la Universidad
dc.relation.publisherversionhttps://journals.lww.com/spinejournal/abstract/2021/11010/implant_microbial_colonization_detected_by.14.aspx
dc.rights.accessRightsinfo:eu-repo/semantics/restrictedAccess
dc.subjectBiofilms
dc.subjectFailed back surgery
dc.subjectImplant
dc.subjectLow grade infection
dc.subjectPedicle screw loosening
dc.subjectSonication
dc.subjectSpinal implant failure
dc.subject.odsNo relacionado con ningún objetivo de desarrollo sostenible
dc.titleImplant microbial colonization detected by sonication as a cause for spinal device failure
dc.typeinfo:eu-repo/semantics/article
dc.type.versioninfo:eu-repo/semantics/publishedVersion
dspace.entity.typePublicationes
relation.isAuthorOfPublication2f2500a1-1b27-4420-820c-db8c16e79afd
relation.isAuthorOfPublication.latestForDiscovery2f2500a1-1b27-4420-820c-db8c16e79afd
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