Spinal implant infections are a serious complications of instrumented spinal fusion surgeries, carrying high morbidity and complex management challenges. Early postoperative infections may manifest with wound-healing issues, back pain, and fevers. Magnetic resonance imaging (MRI) is the preferred imaging modality, but can be limited by metal artifacts. For cases with stable implants, surgical debridement with implant retention combined with at least 12 weeks of antibiotics is currently considered appropriate treatment. Staphylococcal infections are ideally treated with biofilm-active antibiotics. Suppressive antibiotic therapy can be considered when surgical debridement has been delayed or is incomplete, and for those who are poor surgical candidates for another surgery. Chronic infections may present insidiously with implant failure or pseudarthrosis; implant removal or revision is generally pursued. As current guidance is heavily based on the periprosthetic joint infection literature and low-level studies on spinal implant infections, further research on optimizing diagnostic and treatment approaches is needed.

中文翻译：

---

最新综述：脊柱植入物感染的诊断和管理


脊柱植入物感染是器械化脊柱融合手术的严重并发症，发病率高，管理挑战复杂。术后早期感染可能表现为伤口愈合问题、背痛和发烧。磁共振成像 （MRI） 是首选的成像方式，但可能受到金属伪影的限制。对于种植体稳定的病例，手术清创术结合种植体保留联合至少 12 周的抗生素目前被认为是合适的治疗方法。葡萄球菌感染最好用生物膜活性抗生素治疗。当手术清创延迟或不完全时，以及对于不适合再次手术的患者，可以考虑抑制性抗生素治疗。慢性感染可能隐匿地表现为植入物失败或假关节;通常进行植入物移除或修复。由于目前的指南在很大程度上基于假体周围关节感染文献和脊柱植入物感染的低水平研究，因此需要进一步研究优化诊断和治疗方法。