The Journal of Bone and Joint Surgery published a study analyzing deep surgical site infection in patients with growing-rod treatment for early-onset scoliosis.
The researchers examined 379 patients who were treated with growing-rod surgery. The patients were followed for at least two years. Here are 10 observations from the study:
1. 11 percent of the patients — 25 males and 17 females — developed at least one deep surgical site infection, defined as any infection requiring surgical intervention.
2. Average age for the initial growing-rod surgery was 6.3 years with a range of 0.6 years to 13.2 years.
4. For patients who developed the deep surgical site infection, the average time between surgery and first infection was 2.8 years, although the farthest-out infection was reported at 7.9 years.
5. There were 10 patients — 2.6 percent — who developed the surgical site infection before their first lengthening. Another 29 patients developed the infection during the course of the lengthening procedures.
6. Only three patients — 0.8 percent — developed the deep surgical site infection after their final spinal fusion surgery.
7. There were 221 patients with stainless-steel implants and 13.6 percent of them had at least one deep surgical site infection. There were 150 patients with titanium implants and 8 percent developed deep surgical site infections. None of the remaining patients treated with chromium-cobalt implants had deep SSI.
8. Among the 42 patients with deep surgical site infection, 52.4 percent underwent implant removal. Thirteen patients had complete removal and nine patients had partial removal. Neuromuscular etiology and non-ambulatory status increased implant removal possibility to treat the infection.
9. For patients who underwent complete implant removal for deep surgical site infection, six terminated the growing rod treatment. Two patients who had partial implant removal terminated growing rod treatment.
10. The factors increasing risk for deep surgical site infection were:
• Stainless-steel implants
• Non-ambulatory status
• Number of revisions before deep SSI was reported