Author Login

Correspondence to Author: Yi Bao MD^1,2,3,4, Gonghai Han BD⁵,Jiayu Chen MD^1,2,3, Tiannan Zhou MD^1,2,3,Zhi Peng MD^1,2,3,Hui Zhong MD^1,2,3, Xianrun Sun BD^1,2,3,Sheng Lu MD,PhD ^1,2,3*. 

1. Department of Orthopedic Surgery, The First People’s Hospital of YunNan Province, Kunming,Yunnan,China.
2. The Affiliated Hospital of Kunming University of Science and Technology, Kunming,YunNan,China.
3. KeyLaboratory of Digital Orthopaedics of Yunnan Province, Kunming,YunNan,China.
4. Kunming Medical University, Kunming,YunNan,China
5. Pain Department,The Third people’s Hospital of Yunnan Province, Kunming,YunNan,China

DOI: 10.52338/wnsr.2025.4306

Abstract:

Study Design:Retrospective study

Objectives:Adjacent segment infection after posterior lumbar fusion for noninfectious spinal surgery is rare. The incidence, etiology, and treatment of adjacent segment infections are rarely reported, and the objective of this study was to investigate the incidence, risk factors, diagnosis, and treatment of adjacent segment infection(ASI) in patients undergoing posterior lumbar fusion surgery for noninfectious spinal surgery
Methods: This retrospective study included patients who underwent lumbar decompression fusion surgery for the treatment of noninfectious lumbar spine diseases between 2008–2020. Clinical data collected from the First People’s Hospital of Yunnan Province included sex, age, comorbidities, visual analog scale (VAS) scores, Oswestry disability index (ODI) scores, and adjacent segment infections (ASIs).
Results:A total of 6,325 patients undergoing posterior lumbar fusion surgery for noninfectious spinal surgery met the inclusion criteria. Seven patients (0.11%) developed ASIs. Five patients underwent posterior debridement, autologous iliac bone grafting, and prolonged internal fixation. Two patients were cured with combined anti-infectious therapy. Before the operation, the VAS score was 8.57 ± 0.98, the ODI score was 42.86 ± 3.85, the last follow-up VAS score was 2.0 ± 0.82, and the ODI score was 13.29 ± 2.92. At the last followup, all patients had an ASI segment that achieved bony fusion, and posterior lumbar fusion surgery for noninfectious lumbar spine diseases was associated with a 0.11% risk of ASI.
Conclusion: Surgeons should be aware of the risk factors for site infection to be able to avoid its occurrence. Early diagnosis is based on the patient’s symptoms, signs, laboratory tests, MRI examination.Timely application of sensitive antibiotics, intervertebral space debridement, autologous iliac bone graft fusion, and prolonged internal fixationare effective treatment measures.

Keywords:Adjacent segment infection, Surgical site infection, Posterior lumbar fusion surgery, Spinal infection, Treatment, Etiology, Risk factor.

Citation:

Sheng Lu,MD,Adjacent Segment Infection After Posterior Lumbar Fusion Surgery. World Neurosurgery Research 2025.