Medical Student Yale School of Medicine New Haven, Connecticut, United States
Introduction: Surgical site infections (SSIs) are common postoperative complications of spine surgery. The aim of this study was to identify predictive factors of single and multiple reoperations for treatment of infection and characterize implicated microbiology among patients who develop a SSI following spine surgery.
Methods: All adult patients who underwent spine surgery by at a major academic hospital between 2011-2018 were identified. Patients who experienced a SSI following surgery were identified and categorized based on whether they required one or two reoperations for SSI treatment. Patient records were reviewed and patient demographics, comorbidities, treatment variables, and SSI characteristics were assessed.
Results: A total of 35 cases of post-spine surgery SSI were identified, of which 19 patients (54.3%) underwent one reoperation and 16 patients (45.7%) underwent two reoperations for treatment of SSI. Mean age was greater in the two-reoperation cohort (One: 61.29 years old vs. Two: 64.39 years old). SSI location varied between cohorts, with a greater proportion of patients requiring two reoperations having deep SSIs (One: 21.1% vs Two: 31.2%), though organ space SSIs were more common among the single reoperation cohort (One: 78.9% vs Two: 68.8%). I&D was the most commonly performed procedure at the first reoperation in both cohorts, though addition of negative-pressure wound therapy was more common in the two-reoperation cohort (One: 21.1% vs Two: 50.0%). Organisms cultured from SSIs varied, with E. coli (Single: 5.3% vs Two: 25.0%) and MSSA (Single: 15.8% vs Two: 37.5%) being more common in the two-reoperation cohort, and coagulase-negative Staphylococci (Single: 5.3%% vs Two: 0.0%), polymicrobial infections (Single: 10.5% vs Two: 12.5%), and negative cultures (Single: 15.8% vs Two: 6.3%) being more common in the single reoperation cohort.
Conclusion : Patients requiring multiple spine surgery reoperations for infection may benefit from additional targeted antimicrobial treatment.
