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Diabetes associated with increased surgical site infections in spinal arthrodesis

Sam Chen1, Matt V Anderson, Wayne K Cheng

  • 1Department of Orthopaedic Surgery, Loma Linda University, Loma Linda, CA, USA.

Clinical Orthopaedics and Related Research
|February 20, 2009
PubMed
Abstract

Insights

Diabetes mellitus (DM) significantly increases the risk of surgical site infections (SSI) after spinal arthrodesis surgery. This study confirms DM is a primary risk factor, with other examined factors showing no significant association with SSI development.

Area of Science:

  • Orthopedic Surgery
  • Infectious Disease
  • Endocrinology

Background:

  • Diabetes mellitus (DM) is a known risk factor for surgical site infections (SSI).
  • Spinal surgeries, particularly posterior instrumented lumbar arthrodesis, carry an inherent risk of SSI.

Purpose of the Study:

  • To evaluate the association between diabetes mellitus and the development of SSI in patients undergoing elective posterior instrumented lumbar arthrodesis.
  • To confirm previous reports on DM as a risk factor for SSI in spinal surgery.

Main Methods:

  • A retrospective study involving 195 patients who underwent elective posterior instrumented lumbar arthrodesis over a 5-year period.
  • Patients were divided into two groups: 30 with DM and 165 without DM.
  • Analysis included assessment of known SSI risk factors such as age, BMI, ASA class, surgical time, and blood loss.

Main Results:

  • The adjusted relative risk of developing SSI for patients with DM was 4.10 (95% C.I. = 1.37-12.32).
  • No other examined factors (age, gender, tobacco use, BMI, ASA class, antibiotic redosing, surgical time, bone allograft, EBL, drain use) were found to be significant risk factors for SSI in this cohort.

Conclusions:

  • Diabetes mellitus is confirmed as a significant independent risk factor for surgical site infections following spinal arthrodesis.
  • Effective management of diabetes may be crucial in reducing SSI rates in patients undergoing spinal fusion surgery.

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