New Evidence in the Diagnosis and Management of Acute and Chronic Deep Surgical Site Infections of Posterior Thoracolumbar Instrumentations: What are the Options and What are the Consequences?

A new decision-focused review shows that for deep spinal infections after thoracolumbar fusion, the timing of diagnosis is the single biggest factor in success: patients diagnosed within 90 days can usually keep their implants, while those diagnosed after 3 months are about 40 times more likely to need hardware removal.

Organizing surgery around five intraoperative decisions — hardware, cage, bone graft, irrigation, and closure — gives surgeons a practical roadmap for one of spine surgery's most morbid complications.