Infection after anterior spinal fusion for idiopathic scoliosis using the Cotrel-Dubousset-Hopf system: A clinical case series of three patients

Article Figures & Data

Table 1

Patient characteristics of patients who received a Cotrel-Dubousset-Hopf system for idiopathic scoliosis.

Case	Sex	Age at fusion (Years)	Curve type (Lenke)	Fusion levels	Pre-operative Cobb-angle (Degrees)	Cobb-angle with CDH-system	Cobb-angle after system removal
1	♀	16	6C	Th10 -L3	59	45	52
2	♀	22	5C-	Th10 -L3	49	23	29
3	♂	17	5C-	Th10 -L3	54	34	34

Table 2

Summary of symptoms and diagnostic findings.

Symptoms & findings	Case 1	Case 2	Case 3
Late onset back- or abdominal pain	Yes	Yes	No
Fever	No	No	No
Local signs of infection	Painful swelling	Painful swelling	Fistula
ESR, CRP & WBC on presentation	ESR 43 CRP 49 WBC 12,3	ESR 32 CRP 24 WBC 8,9	ESR 24 CRP 30 WBC 10
Suspect radiographs	No	Screw loosening	No
Bonescintigraphy indicating infection	No	Yes	No
CT- or MRI-scan showing abscess or fistula	Yes	Yes	Yes
Time from onset of symptoms to diagnosis	29 months	2 days	4 months
Time between implant placement and removal	78 months	59 months	106 months
Macroscopic findings on revision surgery	Fibrotic and granulation tissue	Pus, granulation tissue, abscess	Fibrotic and granulation tissue, puspocket
Identified pathogen	P. Acnes	No pathogen identified	S. Aureus