Wild spine infections: Long-term outcomes and surgical strategies in refractory postoperative spinal infections
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Most postoperative spinal infections resolve with timely debridement and culture-directed antimicrobial therapy. A minority, however, progress to persistent infection with osseous destruction, mechanical instability, and repeated surgical failure. Evidence-based strategies for managing this high-risk salvage population remain limited. This study aimed to evaluate the long-term clinical, neurological, and radiological outcomes of patients undergoing definitive reconstructive surgery after multiple failed revision procedures for refractory postoperative spinal infection. Methods: We retrospectively reviewed patients who underwent two or more revision surgeries for refractory postoperative spinal infection with associated instability or deformity. Clinical outcomes were assessed with the visual analog scale (VAS), Oswestry disability index (ODI), and Frankel neurological grade; radiological outcomes focused on sagittal alignment. All patients underwent aggressive debridement followed by posterior, anterior, or combined reconstruction, with adjunctive antimicrobial therapy and hyperbaric oxygen. Given the limited sample size, statistical analyses were considered hypothesis-generating. Results: < 0.001). Neurological improvement occurred in 53.8% of patients, with complete recovery in 30.8%. Sagittal segmental alignment improved significantly after surgery, but the magnitude of radiological correction did not correlate with pain or functional outcomes. Conclusion: In refractory postoperative spinal infection requiring salvage reconstruction, restoration of mechanical stability, rather than radiological correction, is the principal determinant of clinical and neurological recovery. Early recognition and timely definitive reconstruction may improve long-term outcomes.
Source: Surgical Neurology International
Institution: Ümraniye Eğitim ve Araştırma Hastanesi
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7224746214