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Related Experiment Video

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In Vivo Mouse Model of Spinal Implant Infection
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Published on: June 23, 2020

Methods to decrease postoperative infections following posterior cervical spine surgery.

Joshua M Pahys1, Jenny R Pahys, Samuel K Cho

  • 1Department of Orthopaedic Surgery, Albert Einstein Medical Center, 5501 Old York Road/WCB 4, Philadelphia, PA 19141, USA.

The Journal of Bone and Joint Surgery. American Volume
|March 22, 2013
PubMed
Summary

Implementing alcohol foam preparation and drains, along with vancomycin powder, significantly reduced surgical site infections in posterior cervical spine surgery. This innovative approach offers a promising method for enhancing patient safety and preventing deep wound infections.

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Area of Science:

  • Neurosurgery
  • Infectious Disease Prevention
  • Surgical Safety

Background:

  • Surgical site infections (SSIs) are a significant concern in posterior cervical spine surgery.
  • Obese patients present a higher risk for SSIs.
  • Previous protocols focused on standard perioperative intravenous antibiotics.

Purpose of the Study:

  • To evaluate the efficacy of a multi-modal protocol in reducing SSIs.
  • To compare infection rates between standard care, alcohol foam with drains, and vancomycin powder with alcohol foam and drains.

Main Methods:

  • Retrospective review of 1001 posterior cervical spine procedures (1995-2010).
  • Three groups analyzed: Control (standard antibiotics), Alcohol Foam and Drain (AD), and Vancomycin with Alcohol Foam and Drain (VAD).
  • Procedures included foraminotomy, laminectomy, laminoplasty, arthrodesis, instrumentation, and osteotomies.

Main Results:

  • Control group (Group C) had 1.86% deep infection rate.
  • Group AD showed a significant decrease in infection rate (1/323) compared to Group C (p=0.047).
  • Group VAD demonstrated zero infections (0/195), a significant reduction compared to Group C (p=0.048).

Conclusions:

  • Alcohol foam preparation and suprafascial drains significantly decreased postoperative deep infections.
  • Addition of intrawound vancomycin powder resulted in no infections and no adverse effects.
  • This technique represents a novel method for substantially reducing SSIs in posterior cervical spine surgery.