{"title":"腹膜后持续局部抗生素灌注治疗腰椎外侧椎体间融合术后手术部位感染1例","authors":"Yawara Eguchi , Noritaka Suzuki , Sumihisa Orita , Kazuhide Inage , Miyako Narita , Yasuhiro Shiga , Masahiro Inoue , Soichiro Tokeshi , Kohei Okuyama , Shuhei Ohyama , Yasuchika Aoki , Junichi Nakamura , Shigeo Hagiwara , Yuya Kawarai , Tsutomu Akazawa , Masao Koda , Hiroshi Takahashi , Seiji Ohtori","doi":"10.1016/j.joscr.2024.05.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Surgical site infection (SSI) after instrumented spinal surgery (ISS) is one of the most serious surgical complications. Treatment is often difficult, with many cases requiring removal of the implant.</div></div><div><h3>Case presentation</h3><div>An 80-year-old man developed refractory MRSA SSI after L4-5 Oblique Lateral Interbody Fusion surgery for a multiply operated back. Local debridement and retroperitoneal continuous local antibiotic perfusion (CLAP) were performed to preserve the implant. One month later, a second CLAP was performed for T6-7 suppurative spondylitis that had disseminated remotely to the thoracic spine. Following this, the lumbar spine and thoracic spine abscess, inflammatory response, and low back pain were reduced dramatically, and the implant was saved.</div></div><div><h3>Conclusion</h3><div>Even in the case of SSI after refractory anterior ISS, CLAP is a procedure worth trying first, as it is easy to install and manage, and will possibly control infection to preserve the implant.</div></div>","PeriodicalId":100743,"journal":{"name":"JOS Case Reports","volume":"3 4","pages":"Pages 190-195"},"PeriodicalIF":0.0000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Retroperitoneal continuous local antibiotic perfusion for surgical site infection after lumbar lateral interbody fusion: A case report\",\"authors\":\"Yawara Eguchi , Noritaka Suzuki , Sumihisa Orita , Kazuhide Inage , Miyako Narita , Yasuhiro Shiga , Masahiro Inoue , Soichiro Tokeshi , Kohei Okuyama , Shuhei Ohyama , Yasuchika Aoki , Junichi Nakamura , Shigeo Hagiwara , Yuya Kawarai , Tsutomu Akazawa , Masao Koda , Hiroshi Takahashi , Seiji Ohtori\",\"doi\":\"10.1016/j.joscr.2024.05.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Surgical site infection (SSI) after instrumented spinal surgery (ISS) is one of the most serious surgical complications. Treatment is often difficult, with many cases requiring removal of the implant.</div></div><div><h3>Case presentation</h3><div>An 80-year-old man developed refractory MRSA SSI after L4-5 Oblique Lateral Interbody Fusion surgery for a multiply operated back. Local debridement and retroperitoneal continuous local antibiotic perfusion (CLAP) were performed to preserve the implant. One month later, a second CLAP was performed for T6-7 suppurative spondylitis that had disseminated remotely to the thoracic spine. Following this, the lumbar spine and thoracic spine abscess, inflammatory response, and low back pain were reduced dramatically, and the implant was saved.</div></div><div><h3>Conclusion</h3><div>Even in the case of SSI after refractory anterior ISS, CLAP is a procedure worth trying first, as it is easy to install and manage, and will possibly control infection to preserve the implant.</div></div>\",\"PeriodicalId\":100743,\"journal\":{\"name\":\"JOS Case Reports\",\"volume\":\"3 4\",\"pages\":\"Pages 190-195\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JOS Case Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2772964824000212\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JOS Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2772964824000212","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Retroperitoneal continuous local antibiotic perfusion for surgical site infection after lumbar lateral interbody fusion: A case report
Background
Surgical site infection (SSI) after instrumented spinal surgery (ISS) is one of the most serious surgical complications. Treatment is often difficult, with many cases requiring removal of the implant.
Case presentation
An 80-year-old man developed refractory MRSA SSI after L4-5 Oblique Lateral Interbody Fusion surgery for a multiply operated back. Local debridement and retroperitoneal continuous local antibiotic perfusion (CLAP) were performed to preserve the implant. One month later, a second CLAP was performed for T6-7 suppurative spondylitis that had disseminated remotely to the thoracic spine. Following this, the lumbar spine and thoracic spine abscess, inflammatory response, and low back pain were reduced dramatically, and the implant was saved.
Conclusion
Even in the case of SSI after refractory anterior ISS, CLAP is a procedure worth trying first, as it is easy to install and manage, and will possibly control infection to preserve the implant.
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