Spinal infections comprise a heterogeneous group of disorders involving the spinal column and adjacent neural elements, including spondylitis, discitis, spondylodiscitis, meningitis, myelitis, spinal epidural abscess, and infectious polyradiculopathy. The use of spinal instrumentation in infected fields remains a debated topic, although recent evidence suggests it may be safe when combined with adequate debridement and antibiotic therapy. Our objective was to evaluate the impact of segmental instrumentation on clinical, laboratory, and microbiological outcomes in patients undergoing surgery for spinal infections. We conducted a retrospective study of 98 adult patients who underwent surgical treatment for spinal infections between 2016 and 2024. Patients were divided into instrumented and non-instrumented groups based on intraoperative decision-making. Clinical outcomes, inflammatory markers, reoperation rates, and hospital stay were analyzed. The results showed that instrumentation was performed in 86 patients, while 12 patients underwent surgery without fixation. Instrumented patients showed comparable infection resolution and clinical recovery despite more severe preoperative presentations. Mean hospital stay was 18.79 days in the instrumented group and 17.91 days in the non-instrumented group. Inflammatory markers improved consistently in the instrumented group. Microbiological confirmation was achieved in approximately half of the cases. In conclusion, segmental instrumentation appears safe in the surgical management of spinal infections when combined with thorough debridement and targeted antibiotic therapy. Clinical outcomes are primarily influenced by infection control rather than the avoidance of implants.
