Risk factors of surgical site infections in instrumented spine surgery

Dobran, Mauro; Marini, Alessandra; Nasi, Davide; Gladi, Maurizio; Liverotti, Valentina; Costanza, Martina Della; Mancini, Fabrizio; Scerrati, Massimo

doi:10.4103/sni.sni_222_17

Cited by 29 publications

(31 citation statements)

References 10 publications

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“…[34][35][36][37][38][39][40] Regarding surgical complications specifically, multiple studies have demonstrated an association between obesity and the incidence of surgical site infections. 35,38,39,41,42 The increased risk for surgical site infections in obese patients has been attributed to the increased risk of fat necrosis in this population, serving as a nidus for infection. Additionally, when utilizing a posterior approach, obese patients can create a more technically demanding procedure due to limited patient mobility and increased difficulty during surgical exposure.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Medical and Surgical Complications After Single-Level Minimally Invasive Transforaminal Lumbar Interbody Fusion

et al. 2020

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Background: The prevention of perioperative and postoperative complications is necessary to avoid poor postoperative outcomes and increased costs. Previous investigations have identified risk factors for complications after various spine procedures, but no such study exists in a population solely undergoing minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). The purpose of this study is to determine risk factors for the development of complications up to 2 years after MIS TLIF procedures. Methods: Patients who underwent primary, single-level MIS TLIF from 2007 to 2016 were retrospectively reviewed. The incidence of medical and surgical complications up to 2 years postoperatively was determined. Patients were categorized according to demographic, comorbidity, and procedural characteristics. Bivariate Poisson regression with robust error variance was used to determine if an association existed between patient characteristics and complication incidence. A final multivariate model including all patient characteristics as controls was created using backwards, stepwise regression until only those variables with P , .05 remained. Results: 390 patients were analyzed. Upon bivariate analysis, age .50 years (P ¼ .025), diabetes mellitus (P ¼ .001), and operative duration .105 minutes (P ¼ .016) were associated with increased medical complication rates. Regarding surgical complications, age 50 years (P , .001), obesity (P ¼ .012), and diabetes mellitus (P ¼ .042) were identified as risk factors on bivariate analysis. Upon final multivariate analysis, operative time .105 minutes (P ¼ .009) and diabetes mellitus (P ¼ .001) were independent risk factors for medical complications. Independent risk factors for surgical complications on multivariate analysis included age 50 years (P , .001), diabetes mellitus (P ¼ .002), and obesity (P ¼ .030). Conclusions: Diabetic patients and those who underwent longer operations were at increased risk of medical complications, while younger patients, obese patients and those also with diabetes mellitus were at increased risk of surgical complications up to 2 years after MIS TLIF. Practitioners can use this information to identify patients who require preventative care before their procedure or increased postoperative vigilance and monitoring after single-level MIS TLIF.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Medical and Surgical Complications After Single-Level Minimally Invasive Transforaminal Lumbar Interbody Fusion

et al. 2020

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“…These results are partly due to pathophysiological changes and high rate of complications secondary to DC. Rebleeding, encephalocele, cerebral infarction, SE, cerebrospinal fluid leakage from incision, intracranial infection, paradoxical herniation, hydrocephalus, skull defect syndrome and epilepsy are main complications [14][15][16]. In this study, the incidence of common complications ranged from 0.9% to 58.3%.…”

Section: Discussionmentioning

confidence: 70%

Size of bone flap in decompressive craniectomy: an analysis of complications and prognosis in traumatic brain injury

Luo

Pan

et al. 2019

Preprint

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Objective: To investigate association of size of bone flap with common complications and prognosis in traumatic brain injury. Methods: A retrospective analysis was performed in 108 TBI patients of Northern Jiangsu People's Hospital from January 2018 to March 2019. Patients’ gender, age, Glasgow Coma Scale at admisson, pupils reactivity to the light, size of bone flap, types of craniocerebral injuries and injury locations were recorded. Prognostic indicators including changes in hematoma volume and neurological status were extracted. Statistical methods were conducted to evaluate drug efficacy. Prognostic indicators including Glasgow Outcome Scale scores at discharge and GOS scores of 6 months after operation were extracted to evaluate surgical effcacy.Results : Postoperative complications such as encephalocele and subdural effusion were significantly associated with size of bone flap ( P <0.05). The incidence of encephalocele and SE increased with bone flap size in bone flap groups. Age, GCS at admisson, pupils reactivity to the light, and size of bone flap were shown significantly differences between prognosis groups ( P <0.05). By binary logistic regression, Age, pupils reactivity to the light, and the size of bone flap showed statistical significance ( P <0.05). Conclusion: Size of bone flap in decompressive craniectomy is a dependent factor to prognosis. Avoiding oversize craniectomy may bring less complications and positive prognosis.

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“…Surgical site infection after instrumented spine surgery is a challenging pathology for diagnosis and treatment. [1][2][3][4] There are many peri-operative risk factors of SSI documented in literature, such as obesity 7 and the described patient was obese with BMI>30.…”

Section: Discussionmentioning

confidence: 99%

“…5,6 In the literature, the and Propionibacterium acnes. [1][2][3][4] The etiopathogenetic mechanism has not yet been clearly defined, but there are two possibilities: contamination of microorganisms during surgery or in the postoperative period and haematogenous spread.…”

Section: -5mentioning

confidence: 99%

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A case of very delayed surgical site infection after instrumented spine surgery

Dobran¹,

Nasi²,

Paracino³

et al. 2018

AMJ

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This is a case of a 69-year-old obese woman treated with posterior spinal stabilization for lumbar degenerative stenosis who developed delayed and persistent surgical site infection sustained by Bacteriodes fragilis. This microorganism is characterized by slow growth and resistance to antimicrobial agents. The patient underwent a surgical treatment with debridement of the surgical wound without hardware removal. After fourteen months the patient had a recurrence of low back pain, low-grade fever and dehiscence of surgical wound with the need of hardware removal. The intra-operative culture was positive for the same microrganism, than she healed with target antibiotic therapy.

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Risk factors of surgical site infections in instrumented spine surgery

Cited by 29 publications

References 10 publications

Risk Factors for Medical and Surgical Complications After Single-Level Minimally Invasive Transforaminal Lumbar Interbody Fusion

Risk Factors for Medical and Surgical Complications After Single-Level Minimally Invasive Transforaminal Lumbar Interbody Fusion

Size of bone flap in decompressive craniectomy: an analysis of complications and prognosis in traumatic brain injury

A case of very delayed surgical site infection after instrumented spine surgery

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