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This review summarizes existing knowledge in the field of PSII, including definitions, epidemiology, classifications, risk factors, pathogenesis, symptoms, diagnosis, and treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A systematic review was performed using a structured PubMed analysis, based on the PRISMA criteria. The search terminology was set as: \u201cspinal implant associated infection OR spinal implant infection OR spinal instrumentation infection OR peri spinal implant infection.\u201d PubMed search was limited to the categories randomized controlled trials (RCT), clinical trials, meta-analysis and (systematic) reviews, whereas case reports were excluded. Studies from January 2000 to December 2020 were considered eligible. A total of 572 studies were identified, 82 references included for qualitative synthesis, and 19 for detailed sub analysis (12 meta-analysis, 7 prospective RCT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Structural problems in the field of PSII were revealed, including (1) limited level of evidence in clinical studies (missing prospective RCT, metanalyzes), (2) small patient numbers, (3) missing standardized definitions, (4) heterogeneity in patient groups, and (5) redundancy in cited literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Evidence-based knowledge about spinal implant-associated infections is lacking. All involved medical fields should come together to define the term PSII and to combine their approaches toward research, training, and patient care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682211024198","type":"journal-article","created":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T05:28:35Z","timestamp":1624253315000},"page":"1231-1246","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["Postoperative Spinal Implant Infections (PSII)\u2014A Systematic Review: What Do We Know So Far and What is Critical About It?"],"prefix":"10.1177","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7409-9002","authenticated-orcid":false,"given":"Daniel","family":"Karczewski","sequence":"first","affiliation":[{"name":"Center for Musculoskeletal Surgery, Department of Orthopaedic Surgery, Charit\u00e9\u2013Universitaetsmedizin Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus J.","family":"Schnake","sequence":"additional","affiliation":[{"name":"Center for Spinal and Scoliosis Surgery, Malteser Waldkrankenhaus St. Marien, Erlangen, Germany"},{"name":"Department of Orthopedics and Traumatology, Paracelsus Private Medical University Nuremberg, Nuremberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5051-0998","authenticated-orcid":false,"given":"Georg","family":"Osterhoff","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Spiegl","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1392-3990","authenticated-orcid":false,"given":"Max J.","family":"Scheyerer","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Trauma Surgery, Medical Faculty, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Ullrich","sequence":"additional","affiliation":[{"name":"Department of Trauma, Hand and Reconstructive Surgery, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany"},{"name":"Department of Trauma and Reconstructive Surgery, BG Clinic Bergmannstrost, Halle (Saale), Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Pumberger","sequence":"additional","affiliation":[{"name":"Center for Musculoskeletal Surgery, Department of Orthopaedic Surgery, Charit\u00e9\u2013Universitaetsmedizin Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,6,21]]},"reference":[{"issue":"5","key":"bibr1-21925682211024198","first-page":"S392","volume":"4","author":"Kasliwal MK","year":"2013","journal-title":"Surg Neurol Int"},{"key":"bibr2-21925682211024198","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-011-1426-0"},{"key":"bibr3-21925682211024198","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-011-1408-2"},{"key":"bibr4-21925682211024198","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"bibr5-21925682211024198","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"key":"bibr6-21925682211024198","unstructured":"Pocket Guide to Diagnosis & Treatment of Spinal Infections. 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