Local Prophylactic Teicoplanin Effect on Spinal Fusion Surgery: A Comparative Retrospective Study

Area of Science:

• Orthopedic Surgery
• Infectious Disease Prevention
• Spinal Fusion Techniques

Background:

• Surgical site infection (SSI) is a major complication following spinal fusion surgery.
• Prophylactic antibiotics are used to reduce SSI risk.
• This study investigates local subfascial antibiotics for preventing SSIs in lumbar spinal stenosis (LSS) surgery.

Purpose of the Study:

• To evaluate the effect of local subfascial teicoplanin versus vancomycin on radiologic and functional outcomes in patients undergoing decompression with posterior instrumentation (DPI) for LSS.
• To compare the efficacy of teicoplanin and vancomycin in preventing SSIs and improving surgical outcomes.

Main Methods:

• A retrospective study of 101 patients with LSS who underwent DPI.
• Patients were divided into three groups: local teicoplanin, local vancomycin, or no local prophylactic antibiotic (control).
• Outcomes assessed included SSI rates, fusion volume, and functional scores (SF-36, Oswestry Disability Index, VAS).

Main Results:

• No significant differences in demographics, follow-up, or functional outcomes were observed among the three groups.
• The SSI rate was lower in the teicoplanin (2/35) and vancomycin (1/34) groups compared to the control (5/32), though not statistically significant (p=0.136).
• Postoperative fusion volume was significantly higher in the teicoplanin group (3.35 cm³) compared to vancomycin (2.68 cm³) and control (2.65 cm³) groups (p=0.007).

Conclusions:

• Local teicoplanin is a viable alternative to vancomycin for preventing SSIs in spinal fusion surgery, despite higher costs.
• Teicoplanin demonstrated a superior bone fusion rate compared to vancomycin and no local antibiotic.
• No significant differences were found in functional outcomes between the groups.