PROGNOSTIC FACTORS FOR POST SPINAL SURGERY INFECTION

Abstract

Background: Postoperative infection of the spine is a feared complication due to increased morbidity and poor patient outcomes and financial burden to health system. Prevention, early diagnosis, and successful treatment strategies are important to reducing morbidity and health care costs. Surgeons should maintain a high index of suspicion for infection and initiate proper diagnostic workup and evaluation when concerned. Objective: The aim of this work is to review preoperative and intraoperative prognostic factors that contribute to develop surgical site infections after spine surgery and discussion of the preventive strategies to minimize risk of infection. Patients and Methods: This is a prospective cross sectional study including 300 patients with one or more prognostic factors who underwent spinal surgeries was surveyed from January 2018 to January 2020 at different levels in neurosurgery department at Al-Hussein University Hospital and Mansoura international hospital. The patients were followed up over period of six months. When patients developed symptoms or signs of surgical site infection, patients were re-admitted to the hospital where the confirming diagnosis and proper management were done. Results: The most relevant factors associated with post spinal surgery infections are spine level, followed by diabetes mellitus and fixation instrumentation. Less relevant factors associated with post spinal surgery infections are sex and smoking. Conclusion: Special concern toward prognostic factors will lead to identification of high risk group, close follow up of these patients by clinical and laboratory and radiological investigations will lead to early diagnosis, early initiation of proper management and taking of preventive measures to reduce this complication.