@article {Khoshbin107, author = {Amir Khoshbin and Magdalena Lysenko and Peggy Law and James G. Wright}, title = {Outcomes of infection following pediatric spinal fusion}, volume = {58}, number = {2}, pages = {107--113}, year = {2015}, doi = {10.1503/cjs.006014}, publisher = {Canadian Journal of Surgery}, abstract = {Background: Removal of instrumentation is often recommended as part of treatment for spinal infections, but studies have reported eradication of infection even with instrumentation retention by using serial d{\'e}bridements and adjuvant antibiotic pharmacotherapy. We sought to determine the effect of instrumentation retention or removal on outcomes in children with spinal infections.Methods: We retrospectively reviewed the cases of patients who experienced early (\< 3 mo) or late (>= 3 mo) infected spinal fusions. Patients were evaluated at least 2 years after eradication of the infection using the following protocol outcomes: follow-up Cobb angle, curve progression and nonunion rates.Results: Our sample included 35 patients. The mean age at surgery was 15.1 {\textpm} 6.0 years, 65.7\% were girls, and mean follow-up was 41.7 {\textpm} 26.9 months. The mean Cobb angle was 63.6{\textdegree} {\textpm} 14.5{\textdegree} preoperatively, 29.4{\textdegree} {\textpm} 16.5{\textdegree} immediately after surgery and 37.2{\textdegree} {\textpm} 19.6{\textdegree} at follow-up. Patients in the implant removal group (n = 21) were more likely than those in the implant retention group (n = 14) to have a lower ASA score (71.4\% v. 28.6\%, p = 0.03), fewer comorbidities (66.7\% v. 21.4\%, p = 0.03), late infections (81.0\% v. 14.3\%, p = 0.01) and deep infections (95.2\% v. 64.3\%, p = 0.03). Implants were retained in 12 of 16 (75.0\%) patients with early infections and 2 of 19 (10.5\%) with late infections. Patients with implant removal had a higher pseudarthrosis rate (38.1\% v. 0\%, p = 0.02) and a faster curve progression rate (5.8 {\textpm} 9.8{\textdegree} per year v. 0.2 {\textpm} 4.7{\textdegree} per year, p = 0.04).Conclusion: Implant retention should be considered, irrespective of the timing or depth of the infection.}, issn = {0008-428X}, URL = {https://www.canjsurg.ca/content/58/2/107}, eprint = {https://www.canjsurg.ca/content/58/2/107.full.pdf}, journal = {Canadian Journal of Surgery} }