Postoperative infection of the spine: management and outcomes at a single institution. A retrospective study.

Abstract

Background: Surgical site infection (SSI) is a potential complication of spine surgery and a significant cause of readmission and surgical revision. Furthermore, the presence of comorbidities, along with the rising frequency of spinal surgeries, may result in secondary infections, thereby elevating the risk of these infections and affecting overall health.

Objective: To assess the study authors' approach for preventing and managing postoperative infections in their center and identify the spine surgeries most susceptible to infection.

Materials and methods: The authors conducted a retrospective study of 2559 patients at a single clinical center who underwent various lumbar spine surgeries, including interlaminar device plus diskectomy, diskectomy, interlaminar device plus recalibration, unilateral recalibration, and bilateral recalibration, among others, between March 1, 2015, and March 31, 2023.

Results: Of these 2559 patients, 54 (2.11%) were readmitted due to infection and underwent reoperation. The most common isolated microorganism was Staphylococcus aureus. Infection occurred in 1.9% of instrumentation surgeries and 2.3% of non-instrumentation surgeries; this difference was not statistically significant. Infected patients received empiric dual antibiotic therapy after sampling of the surgical site and before identification of the causative organisms.

Conclusion: The results of this study indicate that comorbidities increase the risk of infection. However, the authors did not find that instrumentation in spinal surgery escalates this risk. Empiric dual antibiotic therapy was effective in managing SSI prior to identification of the microorganisms via culture.