Moderators: Celeste Abjornson, PhD; Frank P. Cammisa, MD
Implant infection is one of the most serious complications of orthopedic surgery with high associated costs. While every precaution is taken to prevent infection, a small percentage of infections still occur. When these infections are detectable, antibiotic infusions to target the bacteria are often used. However, some bacteria show antibiotic resistance and it has been reported that almost 80% of bacteria show resistance against at least one antibiotic. Moreover, adequate quantities of antibiotic have to be administered systematically to achieve the desired effect locally. Failed back syndrome characterized by chronic pain and disability with or without pseudoarthrosis may simply be a low-grade spinal implant infection that is not detectable by common bloodwork or radiographic imaging. Insidious organisms can exist in low concentrations in a biofilm that surrounds the majority of implant surfaces and may be identifiable only after non-routine ultrasonication techniques and/or longer culture times.
This symposium discusses the current knowledge of bacterial organisms in spinal surgery. Faculty address the evidence supporting precautionary measures taken preoperatively such as surgical site preparation, intraoperatively such as the use of preemptive antibiotics in the surgical site and postoperatively. In addition, new technological advances to limit the surrounding biofilm formation to limit occult infections are reviewed.
Upon completion of this session, participants should gain strategies to:
- Understand the prevalence of occult pathogens in spine surgery;
- Discuss surgical methods such as surgical preparation and topical antibiotics towards reducing infection rates;
- Examine new technology platforms such as anti-microbial surfaces, anti-bacterial coatings, and anti-biofilm coating technologies;
- Understand the prevalence of occult pathogens in spine surgery.
Agenda
Understanding the Role and Formation of Biofilm on Implant Materials
Celeste Abjornson, PhD
Overview of Occult Pathogens in Spinal Surgery: Evidence and Prevalence
Darren Lebl, MD
What Can We Do to Reduce these Risks? Options and Evidence
Jordan Katz, PhD
Randy Clevenger, PhD
Advances in Implant Surfaces: What Do We Have Available Now and Where Are We Going?
Gregory Lutz, MD
Questions and Discussion