Two-Year Outcomes of Postoperative Spine Infection: Implant Retention and Predictors of Treatment Failure.

Background: Postoperative spine infection (PSI) after surgery occurs in approximately 1%-2% of cases and is associated with significant morbidity. High-quality evidence to guide optimal prevention and management of PSI is limited. Methods: We retrospectively identified all adult patients over a 3-year period (2020-2023) who required reoperation for deep PSI. Clinical, microbiological therapy, and 24-month outcome data were collected. Treatment failure was defined as unplanned return to the operating room secondary to persistent infection or infection-related implant failure requiring removal. Descriptive statistics and univariate logistic regression were used to identify factors associated with failure. Results: Sixty-three deep PSI cases were identified (range 18-91 years, median 59 years, 56% female). Onset of infection ranged from 4 days to 30 weeks postoperatively (median 20 days). Conclusions: Most PSIs were effectively managed in this cohort with surgical debridement and targeted antibiotics, allowing implant retention in most patients with instrumentation.