Risk factors for surgical site infections following spinal surgery

The aim of this study was to determine the risk factors for postoperative infection after spinal surgery, in order to prevent its occurrence. We searched the Pubmed, Embase, and Cochrane library databases, and identified 25 case-control studies. The pooled results revealed that the major factors associated with infection were diabetes mellitus (odds ratio [OR] 2.04; 95% confidence interval [CI] 1.69-2.46), obesity (OR 2.13; 95% CI 1.55-2.93), smoking (OR 1.17; 95% CI 1.03-1.32), urinary tract infection (OR 3.19; 95% CI 1.68-6.06), hypertension (OR 1.67; 95% CI 1.26-2.22), transfusion (OR 3.64; 95% CI 2.60-5.08), and cerebrospinal fluid leak (OR 3.22; 95% CI 1.07-9.67). There was insufficient evidence to suggest that male sex, age, alcohol use, and steroid use increased the incidence of infection after spinal surgery. Our analyses suggest strategies to prevent surgical site infection. However, the results should be interpreted with caution because of heterogeneity amongst the included studies.