Clinical outcomes of instrumentation for spinal infection in elderly patients

Abstract

Despite increases in economic status, quality of life, and sanitary conditions, spinal infection remains a serious problem that can be life-threatening.Spinal infection markedly reduces the quality of life because it can lead to pain, neurological deficits (radiculopathy, myelopathy, etc.), deformity and side effects due to the long-term use of antibiotics [1]. Furthermore, the incidence of spinal infections has in-Objective: Spinal infection is a serious problem that is becoming increasingly common as the population ages. The mainstay of spinal infection treatment is proper antibiotic administration, and surgical management is considered if indicated. However, for various reasons, surgery in elderly patients is usually a challenge. The authors performed a retrospective study of operative cases of elderly spinal-infected patients in our hospital to evaluate the effectiveness, safety, and prognosis of spinal instrumentation. Methods: Thirty-five patients (age > 65 years) with spinal infection underwent surgical treatment from 2012 to 2019 and were followed up for more than 1 year. They were divided into two groups: instrumented (group 1) or non-instrumented (group 2). We analyzed the characteristics of patients, clinical outcomes, and surgical data. Results: The preoperative characteristics, postoperative pain relief, improvement of infection, duration of antibiotic use, duration of hospitalization, and perioperative complications did not show statistically significant differences between groups 1 and 2. Spinal infection recurred in one patient in group 1 and five patients in group 2. The recurrence rate was significantly lower in the instrumented group (P = 0.042). The mean period from surgery to ambulation was 6.21 days (range, 1-23 days) in group 1 and 12.56 days (range, 2-34 days) in group 2 (P = 0.049). Conclusion:Instrumentation to elderly patients did not increase the recurrence of infection or the incidence of significant complications in this study. Decompression with instrumentation is a reasonable and effective option for managing spinal infection in elderly patients.