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European Spine Journal

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01-02-2016 | Original Article

Bacterial colonization of VEPTR implants under repeated expansions in children with severe early onset spinal deformities

Authors: Christian Plaass, Carol Claudius Hasler, Ulrich Heininger, Daniel Studer

Published in: European Spine Journal | Issue 2/2016

Abstract

Purpose

Historically, severe spinal and thoracic deformities in children were treated with early long spinal fusions. This prevented further growth of the spine and thorax and often led to small stiff thoraces. Therefore, growth-retaining implants, like vertical expandable titanium ribs (VEPTR), were developed to stimulate thoracic and spinal growth. To accommodate growth, these implants have to be expanded every 6 months. Infection rates of up to 2 % per procedure are reported. Exchange of implant parts allows analyzing the development of implant-related infections and subclinical colonizations.

Methods

In this prospective study, all patients undergoing repeat VEPTR expansion procedures at our institution were included. Preoperatively, clinical signs of infection were documented, and blood samples were taken. The removed implants were treated by sonication and microbiologically analyzed. The clinical follow-up was documented.

Results

From January 2009 to May 2012, 39 children with 163 re-operations were included. Four of the 39 patients (10 %) developed clinical apparent infections and had implant removal. These were excluded and analyzed separately. Of 144 procedures, implant parts were eligible for analysis. Implant colonization was detected by sonication in 24 of 144 (16 %) operations in 18 out of 39 (46 %) patients. Repeated detection occurred in 5 (14 %) patients. No risk factors for colonization could be identified.

Conclusion

The rate of implant colonization is 4.5 times higher than the rate of manifest infections in VEPTR patients. Colonization may lead to a manifest infection over time. The knowledge of persistent implant colonization may change the treatment algorithm in patients with growth-retaining implants.

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Title: Bacterial colonization of VEPTR implants under repeated expansions in children with severe early onset spinal deformities
Authors: Christian Plaass
Carol Claudius Hasler
Ulrich Heininger
Daniel Studer
Publication date: 01-02-2016
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 2/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-015-4003-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Bacterial colonization of VEPTR implants under repeated expansions in children with severe early onset spinal deformities

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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