Does Minimally Invasive Surgery Have a Lower Risk of Surgical Site Infections Compared With Open Spinal Surgery? View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2014-06

AUTHORS

Wen Wei Gerard Ee, Wen Liang Joel Lau, William Yeo, Yap Von Bing, Wai Mun Yue

ABSTRACT

BACKGROUND: Surgical site infection (SSI) ranges from 1.9% to 5.5% in most large series. Minimally invasive surgery (MIS) has been postulated to reduce SSI rates. QUESTIONS/PURPOSES: (1) Is MIS associated with a lower incidence of SSI compared with open spinal surgery? (2) Are there other independent risk factors associated with SSI? (3) What bacteria are most common in spinal SSI? METHODS: Medical records of 2299 patients who underwent transforaminal lumbar interbody fusion, laminectomy, or discectomy were analyzed and selected for a nested case-control analysis. Twenty-seven cases with SSI were matched with 162 control subjects without SSI stratified based on procedure performed within 28 days of the case's date of surgery. Patients were identified from an institutional database at a tertiary care hospital. MIS involved spinal procedures performed through a tubular retractor system. Univariate and multivariate analyses were performed. RESULTS: Patients undergoing open spinal surgery were 5.77 times more likely to develop SSI compared with MIS approaches (odds ratio [OR], 5.77; 95% confidence interval [CI], 1.0-32.7; p = 0.048). Also, from the multivariate regression model, diabetes (OR, 4.7; 95% CI, 1.3-17.0; p = 0.018), number of levels operated on (OR, 3.5; 95% CI, 1.6-7.5; p = 0.001), and body mass index (OR, 1.2; 95% CI, 1.0-1.3; p = 0.010) were predictive of an increased risk in SSI. Staphylococcus aureus was most frequently identified, being present in 12 of 21 (52.4%) patients in whom positive cultures were obtained. Four of the 12 patients had methicillin-resistant S aureus infection. CONCLUSIONS: In our series, MIS has a lower incidence of SSI. The risk factors predictive of SSI should be further evaluated in well-designed prospective trials. LEVEL OF EVIDENCE: Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence. More... »

PAGES

1718-1724

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11999-013-3158-5

DOI

http://dx.doi.org/10.1007/s11999-013-3158-5

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1036285335

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/23846605


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