Efficiency of Hyperbaric Oxygen Therapy in Iatrogenic Spinal Infections

Spine (Phila Pa 1976). 2015 Nov;40(22):1743-8. doi: 10.1097/BRS.0000000000001065.


Study design: Retrospective clinical study.

Objective: The aim of this study is to reveal the effectiveness of HBO therapy in iatrogenic spinal infections intractable to antibiotic therapy alone.

Summary of background data: The efficiency of hyperbaric oxygen (HBO) therapy, which is currently being used in many areas, has been proven in infections in deep and superficial locations and in osteomyelitis. The aim of this study is to reveal effectives of HBO therapy in iatrogenic spinal infections intractable to antibiotic alone therapy.

Methods: HBO therapy was given to 19 cases of iatrogenic spinal infection between 2008 and 2013. Adjuvant HBO therapy was applied to cases that had exhibited no improvement in clinical and laboratory findings despite medical treatment for at least 3 weeks. Several parameters including demographic characteristics, surgical area, etiology and the surgical treatment modality, microbiology (culture material and causative organism), clinical and laboratory results, duration of HBO therapy, and outcome were reviewed.

Results: The mean age was 54.6 years (range: 32-75 years). Iatrogenic spinal infections were most frequent in the lumbar region. It occurred after spine instrumentation in 12 cases and after micro-discectomy in 7 cases. The average number of HBO therapy sessions applied was 20.1 (range: 10-40). Wound discharge and clinical and laboratory findings recovered in all cases at the end of the therapy course. No revision or removal of the instrumentation was necessary in the instrumented cases.

Conclusion: HBO therapy is a treatment modality, which is safe and efficient as an adjuvant therapy in the treatment of infections. It was also seen to be effective in the prevention of revision procedures and instrumentation failures in iatrogenic osteomyelitis cases, which had occurred following spinal instrumentation.

Level of evidence: 4.

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use*
  • Bacterial Infections / drug therapy
  • Bacterial Infections / etiology
  • Bacterial Infections / therapy*
  • Combined Modality Therapy
  • Diskectomy / adverse effects
  • Female
  • Humans
  • Hyperbaric Oxygenation / methods*
  • Iatrogenic Disease
  • Male
  • Middle Aged
  • Spinal Diseases / drug therapy
  • Spinal Diseases / etiology
  • Spinal Diseases / therapy*
  • Spinal Fusion / adverse effects
  • Treatment Outcome


  • Anti-Bacterial Agents