Capacitive coupling reduces instrumentation-related infection in rabbit spines: a pilot study.

BACKGROUND: Postoperative spine infections cause considerable morbidity. Patients are subjected to long-term antibiotic regimens and may require further surgery. Delivery of electric current through instrumentation can detach biofilm, allowing better antibiotic penetration and assisting in eradicating infection. QUESTION/PURPOSES: We asked (1) whether capacitive coupling treatment in combination with a single dose of antibiotics would reduce infection rates when compared with antibiotics alone in a rabbit spine infection model, (2) whether it would decrease the overall bacterial burden, and (3) whether there was a time-dependent response based on days treated with capacitive coupling.
METHODS: Thirty rabbits were subjected to a well-established spine infection model with a single dose of intravenously administered systemic ceftriaxone (20 mg/kg of body weight) prophylaxis. Two noncontiguous rods were implanted inside dead space defects at L3 and L6 challenged with 10(6) colony-forming units of Staphylococcus aureus. Rabbits were randomly treated with a capacitive coupling or control device. Instrumentation and soft tissue bacterial growth were assessed after 7 days.
RESULTS: Sites treated with capacitive coupling showed a decrease in the incidence of positive culture: 36% versus 81% in the control group. We observed no difference in the soft tissue's infectious burden. Overall bacterial load was not decreased with capacitive coupling.
CONCLUSIONS: Capacitive coupling in conjunction with antibiotics reduced the instrumentation-related infection rate compared with antibiotics alone. CLINICAL RELEVANCE: Capacitive coupling noninvasively delivers an alternating current that may detach biofilm from instrumentation. Treatment of infection may be successful without removal of instrumentation, allowing for improved stability and overall decreased morbidity.