Abstract
Aims: To determine whether in operatively treated scoliosis patients loss of correction after implant removal for late infection can be avoided by reinstrumentation.
Methods: A retrospective review of 937 scoliosis patients treated by instrumented posterior fusion. Forty-þve (5%) developed late infection 2.9±1.7(0.5–8.0) yrs p.op. They were treated either by implant removal alone (HR, n=35) or by implant removal, re-instrumentation and augmentation of fusion (RI& F, n=10). Pseudarthrosis was found in 5 patients. Wound healing was uneventful in all patients of both groups after revision. There was no difference in mean Cobb angles between the groups neither before initial scoliosis operation nor before the revision.
The mean follow-up time after revision was 4 years. Results: Radiographically, there was a signiþcant loss of correction after revision operation. At the time of reoperation mean curve correction was 40.4%, being 28.8% at follow-up (p< 0.05).
There was a signiþcant difference in the radiographic outcome between the two revision techniques: In the RI& F-Group, the þnal thoracic Cobb angle correction. was 45.1% as compared to 20.8% in the HR-Group (p=0.03).
Conclusions: One-stage hardware removal and re-instrumentation is a safe procedure and prevents loss of correction in the treatment of late infection after posterior instrumentation and fusion for scoliosis.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
