Risk Factors for Surgical Site Infection Following Orthopaedic Spinal Operations

Olsen, Margaret A.; Nepple, Jeffrey J.; Riew, K. Daniel; Lenke, Lawrence G.; Bridwell, Keith H.; Mayfield, Jennie; Fraser, Victoria J.
January 2008
Journal of Bone & Joint Surgery, American Volume;Jan2008, Vol. 90-A Issue 1, p62
Academic Journal
Background: Surgical site infections are not uncommon following spinal operations, and they can be associated with serious morbidity, mortality, and increased resource utilization. The accurate identification of risk factors is essential to develop strategies to prevent these potentially devastating infections. We conducted a case-control study to determine independent risk factors for surgical site infection following orthopaedic spinal operations. Methods: We performed a retrospective case-control study of patients who had had an orthopaedic spinal operation performed at a university-affiliated tertiary-care hospital from 1998 to 2002. Forty-six patients with a superficial, deep, or organ-space surgical site infection were identified and compared with 227 uninfected control patients. Risk factors for surgical site infection were determined with univariate analyses and multivariate logistic regression. Results: The overall rate of spinal surgical site infection during the five years of the study was 2.0% (forty-six of 2316). Univariate analyses showed serum glucose levels, preoperatively and within five days after the operation, to be significantly higher in patients in whom surgical site infection developed than in uninfected control patients. Independent risk factors for surgical site infection that were identified by multivariate analysis were diabetes (odds ratio = 3.5, 95% confidence interval = 1.2, 10.0), suboptimal timing of prophylactic antibiotic therapy (odds ratio = 3.4, 95% confidence interval = 1.5, 7.9), a preoperative serum glucose level of >125 mg/dL (>6.9 mmol/L) or a postoperative serum glucose level of >200 mg/dL (>11.1 mmol/L) (odds ratio = 3.3, 95% confidence interval = 1.4, 7.5), obesity (odds ratio = 2.2, 95% confidence interval = 1.1, 4.7), and two or more surgical residents participating in the operative procedure (odds ratio = 2.2, 95% confidence interval = 1.0, 4.7).


Related Articles

  • Orthopedic surgery (spine): Total compensation by geographic region.  // MGMA Connexion;Sep2013, Vol. 13 Issue 8, p10 

    Statistics are presented depicting total compensation for spine orthopedic surgery.

  • PERSPECTIVE. Boden, Scott D. // Orthopedics Today;Sep2011, Vol. 31 Issue 9, p62 

    The author comments on research by K. R. O'Neill on the efficiency of vancomycin powder in reducing infection rates in spinal fusion that was published in the 2011 issue of "Spine Journal."

  • Arvind Bhave (ed): Emerging techniques in spine surgery. Gastambide, Daniel // European Journal of Orthopaedic Surgery & Traumatology;May2011, Vol. 21 Issue 4, p313 

    The article reviews the book "Emerging Techniques in Spine Surgery," edited by Arvind Bhave.

  • The Effectiveness of Screening for Scoliosis. Bunge, Eveline M.; de Koning, Harry J. // Pediatrics for Parents;2009, Vol. 25 Issue 2, p10 

    The article offers insights related to the effectiveness of screening for treating scoliosis, an abnormal spinal curvature which usually looks like C or S shape. It notes that screening for scoliosis was introduced around the 1970s in the U.S. and many other countries to prevent patients from...

  • Direct repair of lumbar spondylolysis by Buck's technique. Rajasekaran, S.; Subbiah M.; Shetty, Ajoy Prasad // Indian Journal of Orthopaedics;Mar/Apr2011, Vol. 45 Issue 2, p136 

    Background: The lesion in spondylolysis is a nonunion that follows a fatigue fracture of pars interarticularis. Direct repair of the pars defect is a logical alternative to fusion as it helps to preserve the motion segment and prevents abnormal stresses at the adjacent levels. The purpose of the...

  • Hemoglobin substitutes. Anbari, Kevin K.; Garino, Jonathan P.; Mackenzie, Colin F. // European Spine Journal;Feb2004 Supplement 1, Vol. 13, pS76 

    Orthopaedic patients frequently require blood transfusions to treat peri-operative anemia. Research in the area of hemoglobin substitutes has been of great interest since it holds the promise of reducing the reliance on allogeneic blood transfusions. The three categories of hemoglobin...

  • Aprotinin and major orthopedic surgery. Samama, Charles Marc // European Spine Journal;Feb2004 Supplement 1, Vol. 13, pS56 

    Aprotinin is a potent pharmacological agent that reduces bleeding and limits blood transfusion requirements in current surgical practice. Many studies have been conducted in orthopedic surgery. In several trials performed in total hip replacement (THR) and total knee replacement (TKN) patients,...

  • Spine surgeons can safely perform anterior lumbar surgery without access surgeons. Blisard, Renee // Orthopedics Today;May2012, Vol. 32 Issue 5, p58 

    The article reports on a study which reveals a greater rate of complications when a spine surgeon is assisted by a general surgeon in the exposure procedure.

  • Surgical treatment of the spine at the cervicothoracic junction: an illustrated review of a modified sternotomy approach with the description of tricks and pitfalls. Kn√∂ller, S.; Brethner, L. // Archives of Orthopaedic & Trauma Surgery;Jun2002, Vol. 122 Issue 6, p365 

    The surgical treatment of burst fracture, tumour or spondylitis remains a challenge with regard to the surgical approach to the anterior aspect of the cervicothoracic junction. Many vital structures including osseus, articular, vascular and nervous ones hinder the exposure. Fortunately,...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics