Posterior cranial fossa and spinal local infections
The aim of this paper is to review the current knowledge on the management of local infections in posterior cranial fossa (PCF) and spinal surgery; the center of our paper will be the diagnosis and management of infections of the wound, the subcutaneous tissue, and muscle strata.
Results and conclusions
Very few papers address the problem of local infections in posterior cranial fossa and spinal surgery. The largest amount of the literature data is indeed centered on how to deal with deep infections, CSF leak, and secondary meningitis or hardware infection. Concerning PCF surgery, a higher rate of local infections has been reported, compared with supratentorial surgery. To prevent such complications, prophylaxis remains the most important tool in dealing with local infections; a careful surgical planning and patient selection are also important. On the other hand, in dealing with local infection in spinal setting, there are several evidences that local vancomycin might help reducing them in adults as well as in children. The treatment protocol consists in antibiotic therapy and, whenever needed, wound revision to remove infectious material or to obtain a microbiological diagnosis. Prognosis has overall to be considered favorable both in the short term as well as in the long term.
KeywordsPosterior cranial fossa Spine Infection Local
Compliance with ethical standards
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
- 1.Winn HR (2016) Youmans and Winn Neurological Surgery, vol 4. 7th edn. Elsevier, New YorkGoogle Scholar
- 4.Sciubba DM, Nelson C, Gok B, McGirt MJ, McLoughlin GS, Noggle JC, Wolinsky JP, Witham TF, Bydon A, Gokaslan ZL (2008) Evaluation of factors associated with postoperative infection following sacral tumor resection. J Neurosurg Spine 9:593–599. https://doi.org/10.3171/SPI.2008.9.0861 CrossRefPubMedGoogle Scholar
- 5.WHO (2016) Global Guidelines for the prevention of surgical site infection, GenevaGoogle Scholar
- 7.Theologis AA, Demirkiran G, Callahan M, Pekmezci M, Ames C, Deviren V (2014) Local intrawound vancomycin powder decreases the risk of surgical site infections in complex adult deformity reconstruction: a cost analysis. Spine 39:1875–1880. https://doi.org/10.1097/BRS.0000000000000533 CrossRefPubMedGoogle Scholar
- 9.Tubaki VR, Rajasekaran S, Shetty AP (2013) Effects of using intravenous antibiotic only versus local intrawound vancomycin antibiotic powder application in addition to intravenous antibiotics on postoperative infection in spine surgery in 907 patients. Spine 38:2149–2155. https://doi.org/10.1097/BRS.0000000000000015 CrossRefPubMedGoogle Scholar
- 13.Masumoto K, Nagata K, Oka Y, Kai H, Yamaguchi S, Wada M, Kusuda T, Hara T, Hirose SI, Iwasaki A, Taguchi T (2011) Successful treatment of an infected wound in infants by a combination of negative pressure wound therapy and arginine supplementation. Nutrition 27:1141–1145. https://doi.org/10.1016/j.nut.2011.01.006 CrossRefPubMedGoogle Scholar