ABSTRACT
The number of invasive spinal procedures continues to increase. Performed for a variety of indications, spinal interventions range from diagnostics, such as diskography, myelography, and lumbar puncture, to minimally invasive therapeutics such as epidural steroid injections and intradiscal electrothermal therapy (IDET), to formal open procedures ranging from discectomy to instrumented fusions. Unfortunately, all invasive procedures are associated with a risk for postprocedural infection. As the complexity of the intervention increases, so does the rate of infection (1). Despite improvements in technique, postoperative care, and the development of broad, powerful antibiotics, infectious complications result in significant morbidity and occasional mortality (2). Rates quoted for infection are related to the type of surgery performed as well as the anatomical site of the procedure and range from < 1% to almost 13% (3-7). The key to the management of this potentially devastating problem lies in early diagnosis and aggressive treatment. This chapter focuses on factors involved in the pathogenesis, the clinical presentation, diagnosis and the treatment of postprocedure infection of the spine.
