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Surgical Site Infection After Posterior Lumbar Instrumented Fusions.

Kasra Araghi1, Tejas Subramanian1,2, Takashi Hirase1

  • 1Hospital for Special Surgery, New York, NY, USA.

HSS Journal : the Musculoskeletal Journal of Hospital for Special Surgery
|July 14, 2025
PubMed
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This summary is machine-generated.

Minimally invasive surgery (MIS) and other techniques for lumbar fusion showed low surgical site infection (SSI) rates. While open surgery had a higher observed SSI rate, differences between open, mini-open, and MIS were not statistically significant.

Area of Science:

  • Spine Surgery
  • Infectious Disease Epidemiology
  • Minimally Invasive Procedures

Background:

  • Minimally invasive surgery (MIS) is increasingly adopted for its potential to reduce surgical site infections (SSIs).
  • The comparative impact of MIS versus traditional open techniques on SSIs in lumbar fusion is not well-established.
  • Understanding infection rates across different surgical approaches is crucial for patient outcomes.

Purpose of the Study:

  • To compare surgical site infection (SSI) rates among open, mini-open, and minimally invasive surgery (MIS) techniques.
  • To evaluate the incidence of SSIs in patients undergoing posterior lumbar instrumented fusions.
  • To determine if surgical approach influences SSI risk in this patient population.

Main Methods:

  • Retrospective review of 1382 instrumented 1- or 2-level posterior lumbar fusions (January 2019 - June 2022).
Keywords:
irrigation and debridementlumbar fusionpostoperative infectionspine surgerysurgical site infectionwound infection

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  • Patients categorized into three surgical cohorts: MIS, mini-open, and open.
  • Surgical site infections (SSIs) diagnosed using National Healthcare Safety Network criteria.

    • Main Results:

    • Overall SSI rate was 0.94% (13 of 1382 patients).
    • SSI rates were: MIS (0.3%), mini-open (1.1%), and open (1.3%).
    • No statistically significant difference in SSI rates was found between the three surgical approaches, despite a higher observed rate in the open group.

    Conclusions:

    • Posterior lumbar instrumented fusions, regardless of surgical approach, demonstrated exceptionally low overall SSI rates (0.94%).
    • While the open cohort showed a higher observed SSI rate, insufficient sample size precluded statistical significance.
    • Further research with larger cohorts may be needed to definitively establish differences in SSI rates between MIS, mini-open, and open lumbar fusion techniques.