The Difference of Surgical Site Infection According to the Methods of Lumbar Fusion Surgery

Abstract

The infection rate of PLIF was higher than that of PF or PLF. Considering the increased infection rate in local bone grafted group and 52% of the infection cases after interbody fusion was osteomyelitis around interbody space, contaminated local bones and interbody space were suspected as major routes of contamination. The higher infection rate in single cage group than that of double cage group was attributed to vulnerability of remained avascular disk materials to infection.

An Anti-Infection Tissue-Engineered Construct Delivering Vancomycin: its Evaluation in a Goat Model of Femur Defect

“…Notably, the elimination of potential pathogens located in the surrounding host tissues of the TEC primarily depends on the sufficiency of the local bloodstream, not the controlled release microspheres. This case is similar to some ordinary orthopaedic surgeries 4 where the incidence of infection is very low. Antibiotics released from microspheres are quickly absorbed into the bloodstream, and the diffusion distance is confined.…”

“…During the surgical operation, the open incision is exposed to air for a long time and could result in potential infection by invasive bacteria 4. Furthermore, implanted TEC have an insufficient blood supply, making the immune responses of the host ineffective at the transplantation site as well as obstructing the local delivery of antibiotics from the peripheral blood 5.…”

“…However, treating bone defects or bone fusion involves open surgery, which have long air exposure times and potential for surgical injury that can easily lead to infection. However, if the blood supply at the injury site is sufficient, this issue can be effectively handled 4. When using TEC to treat bone defects, the implanted TEC are devitalised tissues with no blood supply, making it an attractive habitat in which bacteria can live and breed 5.…”

“…These events explain why the infection rate after bone grafting is higher than after general orthopaedic surgery. Previous studies' documented infection rates after implanting an inactive allograft can be as high as 10~16%, while rates in general orthopaedic surgery were 1% 4,6,7. Once infection occurs, it is often followed by very serious consequences that could lead to bone graft failure and poor patient outcomes, including increased morbidity, repeated operations, and long-term antibiotic treatment 8,9.…”

Advancing Technologies for the Diagnosis and Management of Infections

“…58 Bone grafting, which involves implanting devitalized bone, is associated with infection rates of up to 15%. 59 A fibrin gel mix can be created by impregnating the bone graft with vancomycin-alginate beads. Chang and colleagues 60 demonstrated that this antibiotic-impregnated bone graft was capable of bactericidal activity.…”