Abstract:
STUDY DESIGN:A retrospective cohort study. OBJECTIVE:To assess the ability of local vancomycin powder to prevent wound infection after posterior cervical fusion. SUMMARY OF BACKGROUND DATA:Wound infections are a significant source of morbidity and cost associated with spine surgery. Intraoperative application of vancomycin powder to the wound edges has been shown to lower the infection risk after posterior instrumented thoracolumbar fusion. There is little data on the efficacy and safety of local vancomycin powder in cervical spine surgery. METHODS:All cases of posterior cervical fusion by a single surgeon were reviewed from 2007 to 2011. Routine application of 1 gram of vancomycin powder was started in August 2009. Baseline characteristics, operative details, and rates of wound infection and pseudarthrosis were compared between untreated patients and those who received vancomycin powder. RESULTS:A total 171 patients underwent posterior cervical fusion between 2007 and 2011. Baseline and operative variables were similar between untreated patients (n = 92) and those who received vancomycin powder (n = 79). Patients were followed for a minimum of 1 year (range, 1.1-5.7 yr). The infection rate fell from 10.9% to 2.5% (P = 0.0384) following the introduction of vancomycin powder. The untreated and treated groups had similar rates of pseudarthrosis (5.4% vs. 5.1%). No complications attributable to vancomycin powder were identified. CONCLUSION:Routine local application of vancomycin powder is a low-cost effective strategy for preventing wound infection after posterior cervical fusion. Further studies are needed to optimize dosing, assess long-term safety, and evaluate use in other spinal operations. LEVEL OF EVIDENCE:2.
journal_name
Spine (Phila Pa 1976)journal_title
Spineauthors
Strom RG,Pacione D,Kalhorn SP,Frempong-Boadu AKdoi
10.1097/BRS.0b013e318285b219subject
Has Abstractpub_date
2013-05-20 00:00:00pages
991-4issue
12eissn
0362-2436issn
1528-1159journal_volume
38pub_type
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