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Capacitive Coupling Reduces Instrumentation-related Infection in Rabbit Spines: A Pilot Study

  • Symposium: Complications of Spine Surgery
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Postoperative spine infections cause considerable morbidity. Patients are subjected to long-term antibiotic regimens and may require further surgery. Delivery of electric current through instrumentation can detach biofilm, allowing better antibiotic penetration and assisting in eradicating infection.

Question/purposes

We asked (1) whether capacitive coupling treatment in combination with a single dose of antibiotics would reduce infection rates when compared with antibiotics alone in a rabbit spine infection model, (2) whether it would decrease the overall bacterial burden, and (3) whether there was a time-dependent response based on days treated with capacitive coupling.

Methods

Thirty rabbits were subjected to a well-established spine infection model with a single dose of intravenously administered systemic ceftriaxone (20 mg/kg of body weight) prophylaxis. Two noncontiguous rods were implanted inside dead space defects at L3 and L6 challenged with 106 colony-forming units of Staphylococcus aureus. Rabbits were randomly treated with a capacitive coupling or control device. Instrumentation and soft tissue bacterial growth were assessed after 7 days.

Results

Sites treated with capacitive coupling showed a decrease in the incidence of positive culture: 36% versus 81% in the control group. We observed no difference in the soft tissue’s infectious burden. Overall bacterial load was not decreased with capacitive coupling.

Conclusions

Capacitive coupling in conjunction with antibiotics reduced the instrumentation-related infection rate compared with antibiotics alone.

Clinical Relevance

Capacitive coupling noninvasively delivers an alternating current that may detach biofilm from instrumentation. Treatment of infection may be successful without removal of instrumentation, allowing for improved stability and overall decreased morbidity.

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Acknowledgments

We thank Hyunchul Kim, MS, who analyzed and ensured the accuracy of the data, and Daniel Gelb, MD, and Eugene Koh, MD, who oversaw the project and contributed to the writing. We also thank Senior Editor and Writer Dori Kelly, MA, for invaluable assistance editing the manuscript.

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Authors and Affiliations

  1. Department of Orthopaedics, University of Maryland, 22 S Greene Street, S11B, Baltimore, MD, 21201, USA

    Mohit Gilotra MD, Cullen Griffith MD, Jason Schiavone BA, Naren Nimmagadda BS, Jenna Noveau BS & Steven C. Ludwig MD

Authors
  1. Mohit Gilotra MD
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  2. Cullen Griffith MD
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  3. Jason Schiavone BA
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  4. Naren Nimmagadda BS
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  5. Jenna Noveau BS
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  6. Steven C. Ludwig MD
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Corresponding author

Correspondence to Steven C. Ludwig MD.

Additional information

The institution of one or more of the authors (University of Maryland) has received, in any 1 year, grant funding from Biomet, EBI Medical Systems, Inc, and the Orthopaedic Research and Education Foundation. The institution also receives fellowship support from Synthes Spine. Each author certifies that he or she and members of his or her immediate family have no commercial associations that might pose a conflict of interest in connection with the submitted article.

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Each author certifies that his or her institution approved the animal protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

This work was performed at the University of Maryland, Baltimore, MD, USA.

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Gilotra, M., Griffith, C., Schiavone, J. et al. Capacitive Coupling Reduces Instrumentation-related Infection in Rabbit Spines: A Pilot Study. Clin Orthop Relat Res 470, 1646–1651 (2012). https://doi.org/10.1007/s11999-011-2231-1

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  • DOI: https://doi.org/10.1007/s11999-011-2231-1

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