A Biofilm-Based Approach to the Diagnosis and Management of Postoperative Spine Infection

  • Jeremy D. Shaw


Postoperative spine infections are a devastating surgical complication. Historical literature reports postoperative infection rates as high as 20%. Improved surgical techniques and the use of intrawound vancomycin powder have dropped rates in recent years. Importantly, patients who experience a postoperative spine infection have a poorer perceived outcome of their surgery even if it is ultimately successful. In an era of patient-reported outcomes (PROs) driving practice patterns and an aging population undergoing increasing rates of high complexity spine surgery, infection, often complicated by biofilms, remains a key target for quality improvement. This article outlines contemporary standard of care practices for the diagnosis and treatment of postoperative spine infection with an emphasis on emerging concepts and broadly applicable surgical techniques including methylene blue staining as a disclosing agent to identify biofilm-burdened regions.


Spine surgery Infection Deep spine infection Osteomyelitis Diskitis Biofilm 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Jeremy D. Shaw
    • 1
  1. 1.Department of Orthopaedic SurgeryUniversity of Pittsburgh School of MedicinePittsburghUSA

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