A major concern in any surgical procedure is the potential for the patient to develop an infection.  This could, in relatively minor cases, be treated with prophylactic antibiotics or a short course of post-surgical antibiotics and clear up with no lasting effects.  In other cases the patients’ wound may suffer increased scarring and fibrosis caused by the infection, but no other permanent damage.  For patients who develop a systemic and aggressive infection the surgical site may need draining and/or infected material to be removed.  In rare cases a dural tear may occur during surgery which leads to an infection in the spinal fluid and the meninges.  Spinal meningitis can have serious consequences, with loss of limbs, and death possible if the infection does not respond to antibiotic treatment.

Increased Risk Scenarios

Back surgery that uses bone grafts from a cadaver, or hardware during spinal fusion carries a higher risk of infection.  Initially, the infection may be localized in the wound itself, or in the bone but can quickly spread if untreated until systemic infection takes hold and the patient’s condition worsens.  Infection occurs in around 1% of surgeries, and rarely causes serious problems.  Prophylactic antibiotics are likely to be prescribed if the back surgery is considered to have an increased risk of infection (where bone grafts or hardware are to be used), and superficial infections are usually prevented in this way.

Signs of infection

Patients should be aware of the signs of infection so as to begin treatment early if necessary.  Some pain and redness at the incision site is usual but heat, swelling, and redness that extends beyond 1cm or so from the incision may indicate a problem.  Fluid seepage from the wound can also highlight the presence of infection, particularly where the liquid becomes thick and yellow.  Anyone with these symptoms and patients with a fever, shaking, chills, and headache should seek medical attention immediately.  For superficial infection the patient may have their stitches removed, but for deeper infections there may be a need for surgery to drain the infection, remove dead tissue, and in some cases remove the hardware to allow the body to heal.

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