Which Risk Factors are Important in Spinal Infection?

Infection is the most common complication of spinal surgeries. Surgical site infection (SSI) can result in high hospitalisation costs owing to prolonged hospital stays, repeated surgeries and an increase in the frequency of pseudoarthrosis.
The purpose of this study was to identify the risk factors of SSI in patients treated with thoracolumbar posterior spinal instrumentation.
Inclusion criteria were treated by posterior thoracolumbar stabilization with transpedicular screw and posterolateral fusion in the neurosurgery clinic between March 2006 and June 2009. Overall, 260 consecutive patients were identified and 239 patients included in this study. Risk factors that may cause increase of rate of SSI were evaluated.
There were 153 female and 86 male patients with 48.23 ± 16.77 year-old. In all patients, the SSI rate was 12.5% (n = 30). Ten out of these 30 patients (4.1%) had deep wound infections and 20 patients (8.4%) had superficial infections. The average duration of infection development was 13.26 ± 10.96 days. The most isolated bacteria was Staphylococcus aureus (n = 10). Trauma as primary diagnosis, diabetes mellitus and other concomitant chronic systemic diseases, long operation time, excess blood loss during operation and excess blood product transfusion, intraoperative dural injury and presence of additional operations after primary operation were risk factors in the development of SSI. Length of postoperative ICU stays was determined to be a significant risk factor also.
It is important to know the risk factors of the patient and the surgery to reduce the frequency of infection. The gold standard in infection control is to prevent development of SSI.