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How would you manage and determine the duration of antibiotics for a patient with suspected chronic postoperative spinal implant infection, status post lumbar fusion, now presenting with loosened hardware on imaging, normal inflammatory markers, and no systemic infection symptoms?
Answer from: at Academic Institution
Loosening can be identified as lucency around pedicle screws on standard radiography, commonly at the upper or lower ends of the surgical construct. It was graded on a scale of 0-3. High-grade loosening (grade 2 or 3) is associated with increased odds of requiring revision surgery. It can be mechani...
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Answer from: at Community Practice
Follow-up: The patient is 8 weeks status post (s/p) revision of non-union. The decision post-op was to withhold antibiotics pending cultures. All intra-operative cultures for bacteria, fungi, and mycobacteria have been finalized with no growth. The patient is clinically improved and increasingly mob...