Retroperitoneal continuous local antibiotic perfusion for surgical site infection after lumbar lateral interbody fusion: A case report

Surgical site infection (SSI) after instrumented spinal surgery (ISS) is one of the most serious surgical complications. Treatment is often difficult, with many cases requiring removal of the implant. An 80-year-old man developed refractory MRSA SSI after L4-5 Oblique Lateral Interbody Fusion surgery for a multiply operated back. Local debridement and retroperitoneal continuous local antibiotic perfusion (CLAP) were performed to preserve the implant. One month later, a second CLAP was performed for T6-7 suppurative spondylitis that had disseminated remotely to the thoracic spine. Following this, the lumbar spine and thoracic spine abscess, inflammatory response, and low back pain were reduced dramatically, and the implant was saved. Even in the case of SSI after refractory anterior ISS, CLAP is a procedure worth trying first, as it is easy to install and manage, and will possibly control infection to preserve the implant.