Single Stage Revision of Infected Posterior Lumbar Fixation Using Nano-Silver Coated Pedicle Screws and Rod System

Objectives: Silver coated implants have been used in human due to its known antimicrobial properties and biocompatibility. With scarcity of similar studies in the spine, the purpose of this study is to evaluate the early clinical and radiological outcomes of nano-silver coated titanium pedicle screw system in single stage exchange of infected posterior spinal fixation.

Methods: This is a retrospective study of sixteen consecutive cases who had an established posterior spinal infected fixation and were managed with surgical debridement and single stage revision fixation using Silver coated titanium screws and rods system. Patients were 9 males and 7 females with a mean age of 45 years (range 23 years-74 years)

Results: After a mean follow up of 19 months (range 14 months-25 months), 14 cases (87.5%) had successful revisions with resolution of infection and stable spinal fixation. One case had transient neurological deficit and two other cases had persistent wound infection that necessitated two stage revision surgery. The mean VAS score for pain has improved from 7.18 ± 1.83 preoperatively to 2.62 ± 2.8 at final follow up.

Conclusion: Single stage revision of infected spinal fixation using silver coated screws system along with debridement may be a viable option. Comparative studies, with larger patient number and longer follow up are required to properly assess the longer-term efficacy and cost benefit.