Postoperative synergistic gangrene after spinal fusion

Study Design. A case of synergistic necrotizing gangrenous fasciitis after spinal surgery is reported. Objectives. To describe this unusual complication, explain the rationale of treatment, and increase awareness of this serious postoperative complicati on. Summary of Background Data. Although several cases of postoperative synergi stic necrotizing fasciitis have been reported, there are no previously repo rted cases of this condition after spinal surgery. Methods. A rapidly progressive necrotizing spinal wound infection after fus ion for degenerative disc disease was treated in a 39-year-old man. Results. The infection was successfully treated with serial debridements, a ppropriate antibiotics, and hyperbaric wound oxygenation. Conclusions. The authors suggest adherence to the fundamental principles of treatment including radical surgical debridement and appropriate antibiosi s for necrotizing gangrene after spinal surgery. In evaluation of aggressiv e spinal wound infections, diagnosis of synergistic necrotizing fasciitis s hould be kept in mind. Although hyperbaric wound oxygenation was implemente d as an adjunct and appeared to aid in controlling the infection, its effec t on outcome is not clear.