Delayed Infection 34 Months After IntraSPINE(®) Dynamic Internal Insertion

INTRODUCTION: Postoperative surgical site infection remains one of the major complications after spinal surgery. IntraSPINE(®) (intraspine) is a dynamic intralaminar device introduced by Cousin Biotech and is indicated for the surgical treatment of lumbar spine disorders. There are no reports on delayed surgical site infection (SSI) after lumbar surgery using this device. CASE PRESENTATION: A 29-year-old male patient was admitted to our department with complaints of moderate pain and chronic subcutaneous abscess with purulent flow from his old surgical scar. Thirty-four months ago, he underwent a traditional open bilateral L4 laminotomy without discectomy and intraspine insertion for the treatment of L4-5 central lumbar spinal stenosis at another hospital. The patient was discharged 4 days after surgery without radiating pain, and the surgical wound was well healed. He gradually returned to his normal activity and work. However, he experienced moderate pain, redness and swelling of his old surgical scar approximately one month before coming to our hospital, but he did not receive any treatment. One month later, he had a mass with purulent discharge at the surgical scar site, and he visited our hospital on December 29th, 2020. Based on the physical examination and MRI findings, delayed -SSI was diagnosed. The patient underwent removal of the intraspine device, debridement and wound closure with closed drainage. The wound healed satisfactorily, and the patient had no complaints more than 2 years later. CONCLUSION: A delayed surgical site infection following intraspine insertion may have occurred.