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Post-surgical implant-associated spinal infection is a devastating complication commonly caused by  Staphylococcus aureus . Biofilm formation is thought to reduce penetration of antibiotics and immune cells, contributing to chronic and difficult-to-treat infections. A rabbit model of a posterior-approach spinal surgery was created, in which bilateral titanium pedicle screws were interconnected by a plate at the level of lumbar vertebra L6 and inoculated with a methicillin-resistant  S  .   aureus  (MRSA) bioluminescent strain.  In vivo  whole-animal bioluminescence imaging (BLI) and  ex vivo  bacterial cultures demonstrated a peak in bacterial burden by day 14, when wound dehiscence occurred. Structures suggestive of biofilm, visualized by scanning electron microscopy, were evident up to 56 days following infection. Infection-induced inflammation and bone remodeling were also monitored using  18 F-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography (PET) and computed tomography (CT). PET imaging signals were noted in the soft tissue and bone surrounding the implanted materials. CT imaging demonstrated marked bone remodeling and a decrease in dense bone at the infection sites. This rabbit model of implant-associated spinal infection provides a valuable preclinical  in vivo  approach to investigate the pathogenesis of implant-associated spinal infections and to evaluate novel therapeutics.

Rabbit model of Staphylococcus aureus implant-associated spinal infection