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Published on: June 23, 2020
Infection rate after minimally invasive noninstrumented spinal surgery based on 4350 procedures
Mootaz Shousha1, Dusan Cirovic, Heinrich Boehm
1*Zentralklinik Bad Berka, Bad Berka, Thüringen, Germany; and †Alexandria University, Alexandria, Egypt.
Study Design:
Retrospective review of a prospectively collected database.
Objective:
To assess the rate of postoperative infection associated with minimally invasive noninstrumented spinal surgery.
Summary Of Background Data:
Infection after spinal surgery results in significant morbidity, extended hospital stay, and significant costs. Minimally invasive spinal techniques require smaller incisions and less dissection, minimizing the risk of postoperative infection.
Methods:
Inclusion criteria were patients undergoing posterior spinal surgery using a tubular retractor system with the aid of operative microscope between June 1998 and November 2013. The analysis revealed a total number of 4350 procedures performed in 4037 patients (mean age=53.2 yr). Sixty percent of the patients were male. The majority of procedures were performed in the lumbar spine (98.4%), and the indication was mostly degenerative in nature (96.9%). The databases were then reviewed for any infectious complications.
Results:
Postoperative infection was recorded in 4 patients (0.09%). All of them occurred in the lumbar region after discectomy. These patients presented with discitis and underwent revision in the form of open debridement and fusion. The time lapse between the index surgery and revision was 56 days. All 4 patients recovered, with a mean follow-up of 7.5 years.
Conclusion:
Infection rate after posterior transtubular microscopic assisted spinal surgery is very low (0.09%). Surgical debridement with fusion was the method of choice in treating such complications. This minimally invasive technique reduces markedly the risk of postoperative infection when compared with other large series published in the literature.
Level Of Evidence:
4.
Insights
Minimally invasive spinal surgery using microscopic assistance has a very low postoperative infection rate of 0.09%. This technique significantly reduces infection risk compared to traditional methods, with effective treatment via debridement and fusion.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Spinal Surgery
Background:
- Spinal surgery infections lead to significant patient morbidity, prolonged hospital stays, and increased healthcare costs.
- Minimally invasive spinal techniques, characterized by smaller incisions and reduced tissue dissection, are hypothesized to lower the risk of postoperative infection.
Purpose of the Study:
- To evaluate the incidence of postoperative infection following minimally invasive, noninstrumented spinal surgery.
- To determine the efficacy of minimally invasive techniques in reducing surgical site infections.
Main Methods:
- A retrospective review was conducted on a prospectively collected database of patients undergoing posterior spinal surgery.
- Inclusion criteria involved procedures using a tubular retractor system and operative microscope between June 1998 and November 2013.
- The study analyzed 4350 procedures in 4037 patients, primarily for degenerative lumbar spine conditions.
Main Results:
- A total of 4 postoperative infections (0.09%) were identified among the 4350 procedures.
- All infections occurred in the lumbar spine following discectomy, presenting as discitis.
- These patients required revision surgery involving open debridement and fusion, with complete recovery after a mean follow-up of 7.5 years.
Conclusions:
- Posterior transtubular microscopic-assisted spinal surgery demonstrates a very low postoperative infection rate of 0.09%.
- Surgical debridement with fusion is an effective treatment for managing infections after this minimally invasive procedure.
- The findings suggest that this minimally invasive approach significantly lowers the risk of postoperative infection compared to traditional spinal surgery methods.
