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The Effect of Topical Vancomycin Powder Application on the Rate of Intervertebral Fusion Following Lumbar Fusion: A
Sheng-Jie Xu1, Xiao-Lin Liu1, Jin-Peng Shi1
1Department of Orthopedic Surgery, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.
Purpose:
The occurrence of surgical site infection (SSI) after lumbar spinal fusion is a serious complication. Therefore, an increasing number of clinicians are applying vancomycin powder topically in the surgical field to reduce the incidence of SSI. However, there is concern that topical vancomycin powder application may affect intervertebral fusion. The purpose of this study was to analyse the effect of clinically relevant topical vancomycin doses on the rate of intervertebral fusion after lumbar fusion and to further investigate the effect of vancomycin powder on the prevention of SSI.
Methods:
The clinical data of 192 patients with degenerative lumbar spine disease admitted from January 2019 to June 2022, all of whom underwent posterior lumbar fusion, were retrospectively analysed. According to the infection prevention protocol, they were divided into a vancomycin group and a control group (no vancomycin), and the vancomycin group was sub-divided into 0.5 g, 1.0 g, and 1.5 g vancomycin groups. General information and surgical evaluation indexes were compared between the control and vancomycin groups and intervertebral fusion was compared between the vancomycin groups at 6 months and 12 months, postoperatively.
Results:
The rate of SSI in the vancomycin group was 0.0%, which was significantly lower than that in the control group (5.3%, P < 0.05), and intervertebral fusion was good in all 3 vancomycin groups at 6 months and 12 months postoperatively, with no statistically-significant differences (P > 0.05).
Conclusions:
Topical application of 0.5 g, 1.0 g, or 1.5 g vancomycin powder did not affect the rates of intervertebral fusion after lumbar fusion. In addition, topical application of vancomycin powder significantly reduced the rates of SSI.
Insights
Topical vancomycin powder effectively prevents surgical site infections after lumbar fusion without compromising intervertebral fusion rates. This study confirms its safety and efficacy in reducing infection complications.
Area of Science:
- Orthopedic Surgery
- Infectious Disease Prevention
- Spinal Fusion Techniques
Background:
- Surgical site infection (SSI) is a significant complication following lumbar spinal fusion.
- Topical vancomycin powder is increasingly used to mitigate SSI risk.
- Concerns exist regarding vancomycin's potential impact on intervertebral fusion rates.
Purpose of the Study:
- To evaluate the effect of topical vancomycin doses on intervertebral fusion after lumbar fusion.
- To assess the efficacy of vancomycin powder in preventing SSI.
- To analyze clinically relevant doses of vancomycin for safety and efficacy.
Main Methods:
- Retrospective analysis of 192 patients undergoing posterior lumbar fusion.
- Division into vancomycin and control groups; vancomycin group further divided by dose (0.5g, 1.0g, 1.5g).
- Comparison of SSI rates and intervertebral fusion at 6 and 12 months post-surgery.
Main Results:
- Zero SSI rate in the vancomycin group versus 5.3% in the control group (P < 0.05).
- Good intervertebral fusion observed in all vancomycin dose groups at 6 and 12 months.
- No statistically significant difference in fusion rates between vancomycin groups (P > 0.05).
Conclusions:
- Topical vancomycin powder (0.5g, 1.0g, 1.5g) does not impede intervertebral fusion after lumbar fusion.
- Vancomycin powder significantly reduces the incidence of SSI.
- Topical vancomycin is a safe and effective adjunct for preventing SSI in lumbar fusion procedures.
