Abstract
Objective:To assess the prophylactic effects of local vancomycin on an infection of the surgical site in patients undergoing lumbar instrumented fusion.Methods:Retrospective study from January 2011 to June 2014 in patients with symptomatic and refractory lumbar spine stenosis and listhesis who underwent instrumented pedicle screw spinal fusion. Two groups of patient were analyzed, one using vancomycin on the surgical site, vancomycin group (VG) and the control group (CG) without topical vancomycin. The routine prophylactic procedures were performed in both groups: aseptic scrub technique, skin preparation, preoperative intravenous antibiotic therapy. The VG received a dose of 1g of vancomycin mixed with the bone graft every three spinal levels fused and the group consisted of 232 patients.Results:513 patients were analyzed, 232 in the VG and 281 in the CG. There was no statistical difference between the groups when the sex, mean surgery length, and mean bleeding volume were considered. The rate of infection for VG was reduced from 4.98% to 1.29% when compared with CG.Conclusion:The use of vancomycin added to the bone graft in posterior spinal fusion is associated with significantly lower rates of infection.
Highlights
Surgical site infections in spinal surgery with instrumentation are a complication that increases patient morbimortality and treatment costs due to prolonged hospitalization, multiple surgical procedures and the use of specific antibiotics.[1,2] The rates of surgical site infection after spinal surgeries with decompression or fusion without instrumentation reported in the literature range from 0.7 to 2.3%.3–6 The use of instrumentation in spinal fusion increases the rates of postoperative infection from 0.3 to 20%.7–17The most commonly isolated organism in surgical site infections is Staphylococcus aureus (SA) both methicillin-sensitive (MSSA) and methicillin-resistant (MRSA)
The aim of this study is to evaluate whether surgical site vancomycin mixed in bone grafts decreases infection rates in patients undergoing lumbosacral instrumented spine fusion
Exclusion criteria were surgeries performed by anterior approach, pediatric surgery, surgery without instrumentation, thoracic or thoracolumbar spine surgery, use of interbody cage, oncologic or traumatic surgery, previous surgical site infections, known allergy to vancomycin, and patients who did not agree to participate in the study
Summary
Surgical site infections in spinal surgery with instrumentation are a complication that increases patient morbimortality and treatment costs due to prolonged hospitalization, multiple surgical procedures and the use of specific antibiotics.[1,2] The rates of surgical site infection after spinal surgeries with decompression or fusion without instrumentation reported in the literature range from 0.7 to 2.3%.3–6 The use of instrumentation in spinal fusion increases the rates of postoperative infection from 0.3 to 20%.7–17The most commonly isolated organism in surgical site infections is Staphylococcus aureus (SA) both methicillin-sensitive (MSSA) and methicillin-resistant (MRSA). Surgical site infections in spinal surgery with instrumentation are a complication that increases patient morbimortality and treatment costs due to prolonged hospitalization, multiple surgical procedures and the use of specific antibiotics.[1,2] The rates of surgical site infection after spinal surgeries with decompression or fusion without instrumentation reported in the literature range from 0.7 to 2.3%.3–6. The use of instrumentation in spinal fusion increases the rates of postoperative infection from 0.3 to 20%.7–17. Surgeons must take a number of measures to try to control and reduce the risk of surgical site infections inherent either to the procedure (operative time, blood loss, use of instrumentation and revision surgeries) or to the patient (obesity, advanced age, malnutrition, smoking history, diabetes).[8,18,19]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
