The Use of Antibiotics Impregnated Bone Cement in Reducing Surgical Site Infections in Spine Surgery: A Systematic Review.

Abstract

Background and study aims: Spine surgeries are one of the most widely accepted method of surgery in orthopaedics. However, one of the most common complications of spine surgeries is surgical site infection (SSI), that associated with various post operative morbidities. The use of antibiotics impregnated bone cement (AIBC) is common in orthopaedics surgeries. Therefore, we aim to provide comprehensive review of AIBC use in spine surgeries.

Methods: Data was gathered from PubMed, Europe PMC, and ScienceDirect using keywords associated with AIBC and spine surgeries. We included all publications associated with AIBC and spine surgeries. Studies without full paper, non-English publications, review articles, and animal or cadaveric studies are excluded. The quality of each included studies assessed using Newcastle Ottawa Scale (NOS) and Joana Briggs Institute (JBI) Critical Appraisal for case reports, case series, and quasi experimental studies.

Results: 15 studies with total of 322 patients using AIBC in spine surgery were included. 10 of 15 studies reported 100% infection-free event with AIBC administration with or without given systemic antibiotics. Two studies did not report 100% infection free event due to MRSA infections and technical causes. 3 studies reported the use of AIBC without disclosing outcomes. Various types of bacteria ranging from MSSA to MRSA have been discovered, with PMMA and vancomycin being the most frequently used AIBC.

Conclusion: Antibiotics impregnated bone cement can be used to prevent post-operative infections due to its high effectiveness, easy administration, and no side effects have ever been reported. Further studies are needed to determine the most appropriate antibiotics, dose, and type of cement.