Is dental prophylaxis required following spinal fusion?—a systematic review and call for evidence

Martin, Parker; Hundal, Rajbir S.; Matulich, Kathryn; Porta, Maria Libera La; Patel, Rakesh; Aleem, Ilyas

doi:10.21037/jss.2020.03.03

Cited by 2 publications

(4 citation statements)

References 14 publications

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“…Antibiotic prophylaxis for invasive dental procedures did not prevent postoperative infections after spinal surgery, and receiving dental treatment as early as 3 months after spinal surgery did not increase the risk of postoperative infection. These findings can be helpful in establishing an evidence‐based guideline for antibiotic prophylaxis before dental treatment in patients who have undergone spinal surgery (Martin et al, 2020 ). Older age, male sex, congestive heart failure, peripheral vascular disease, cerebrovascular disease, peptic ulcer disease, mild liver disease, diabetes, renal disease, malignancy, and metastatic solid tumour were other risk factors for PSI.…”

Section: Discussionmentioning

confidence: 99%

“…However, due to the lack of clinical evidence, it has been dependent only on expert opinion until now. The majority of spinal surgeons recommend against prescribing prophylactic antibiotics before the dental procedure to patients with uncomplicated lumbar fusion (Lewkonia et al, 2016 ; Martin et al, 2020 ). However, in actual clinical practice, dentists prescribe antibiotics before the procedure at a fairly high rate.…”

Section: Discussionmentioning

confidence: 99%

“…Antibiotic prophylaxis for invasive dental procedures did not prevent postoperative infections after spinal surgery, and receiving dental treatment as early as 3 months after spinal surgery did not increase the risk of postoperative infection. These findings can be helpful in establishing an evidence-based guideline for antibiotic prophylaxis before dental treatment in patients who have undergone spinal surgery (Martin et al, 2020) Infective endocarditis is a rare but life-threatening disease, with a mortality rate of 25% (Wallace et al, 2002). Therefore, the use of prophylactic antibiotics is recommended during procedures that pose a risk of endocarditis in patients with certain underlying diseases (Wilson et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

“…They recommended against prescribing prophylactic antibiotics before dental procedures and advised oral hygiene. However, this guideline can be applied only to patients with hip and knee prosthetic joint implants, and an evidence‐based guideline for cases of spinal surgery with instrumentation has not been proposed yet (Martin et al, 2020 ). There have been no objective studies on the effectiveness of antibiotic prophylaxis in these patients.…”

Section: Introductionmentioning

confidence: 99%

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Invasive dental procedures as risk factors for postoperative spinal infection and the effect of antibiotic prophylaxis

Sung

Kim

Kwon

et al. 2021

J Clinic Periodontology

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Aim To identify invasive dental procedures as a risk factor for postoperative spinal infection (PSI) and evaluate the effectiveness of antibiotic prophylaxis. Materials and Methods We analysed 229,335 patients who underwent spinal surgery with instrumentation from 2010 to 2017, using the nationwide database. The incidence of spinal infection 2 years after surgery was determined. Invasive dental procedures as a risk factor for PSI and the effects of antibiotic prophylaxis during this period were also analysed. Results A total of 15,346 patients (6.69%) were diagnosed with PSI. It was found that advanced age, male sex, and a high Charlson Comorbidity Index were risk factors for PSI. The risk of PSI did not increase following dental procedures (adjusted hazard ratio [HR] 0.850; 95% confidence interval [CI], 0.793–0.912) and was not affected by antibiotics (adjusted HR 1.097; 95% CI, 0.987–1.218). Patients who received dental treatment as early as 3 months after spinal surgery had the lowest risk of postoperative infection (adjusted HR 0.869; 95% CI, 0.795–0.950). Conclusions Invasive dental procedure does not increase the risk of PSI, and antibiotic prophylaxis before dental procedure was not effective in preventing spinal infection.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Antibiotic prophylaxis for invasive dental procedures did not prevent postoperative infections after spinal surgery, and receiving dental treatment as early as 3 months after spinal surgery did not increase the risk of postoperative infection. These findings can be helpful in establishing an evidence-based guideline for antibiotic prophylaxis before dental treatment in patients who have undergone spinal surgery (Martin et al, 2020) Infective endocarditis is a rare but life-threatening disease, with a mortality rate of 25% (Wallace et al, 2002). Therefore, the use of prophylactic antibiotics is recommended during procedures that pose a risk of endocarditis in patients with certain underlying diseases (Wilson et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations