The Spine Journal
Volume 10, Issue 5 , Pages 410-416 , May 2010

Surgical site infection after osteotomy of the adult spine: does type of osteotomy matter?

  • Albert F. Pull ter Gunne, MD

      Affiliations

    • Department of Orthopaedic Surgery, Johns Hopkins Hospital, 601 N Caroline St, Baltimore, MD 21287, USA
    • Corresponding Author InformationCorresponding author. Department of Orthopaedic Surgery, Johns Hopkins Hospital, 601 N Caroline St, Baltimore, MD 21287, USA. Tel.: (410) 955-0981; fax: (410) 614-1451.
  • ,
  • C.J.H.M. van Laarhoven, MD, PhD

      Affiliations

    • Department of General Surgery, Universitair Medisch Centrum St Radboud, Afdeling Heelkunde Huispost 690, Route 690, Postbus 9101, 6500 HB, Nijmegen, The Netherlands
  • ,
  • David B. Cohen, MD, MPH

      Affiliations

    • Department of Orthopaedic Surgery, Johns Hopkins Hospital, 601 N Caroline St, Baltimore, MD 21287, USA

Received 6 August 2009 ,Revised 2 October 2009 ,Accepted 15 November 2009.

References 

  1. Abbey DM, Turner DM, Warson JS, et al. Treatment of postoperative wound infections following spinal fusion with instrumentation. J Spinal Disord. 1995;8:278–283
  2. Balderston RA, Blumberg KD. Infection in spine surgery. In:  Balderston RA, An HS  editor. Complications in spinal surgery. Philadelphia, PA: WB Saunders; 1991;p. 157–168
  3. Glassman SD, Dimar JR, Puno RM, Johnson JR. Salvage of instrumental lumbar fusions complicated by surgical wound infection. Spine. 1996;21:2163–2169
  4. Keller RB, Pappas AM. Infection after spinal fusion using internal fixation instrumentation. Orthop Clin North Am. 1972;3:99–111
  5. Lonstein J, Winter R, Moe J, Gaines D. Wound infection with Harrington instrumentation and spine fusion for scoliosis. Clin Orthop. 1973;96:222–233
  6. Olsen MA, Mayfield J, Lauryssen C, et al. Risk factors for surgical site infection in spinal surgery. J Neurosurg Spine. 2003;98:149–155
  7. Roberts FJ, Walsh A, Wing P, et al. The influence of surveillance methods on surgical wound infection rates in a tertiary care spinal surgery service. Spine. 1998;23:366–370
  8. West JL, Ogilvie JW, Bradford DS. Complications of the variable screw plate pedicle screw fixation. Spine. 1991;16:576–579
  9. Kostuik JP, Israel J, Hall JE. Scoliosis surgery in adults. Clin Orthop. 1973;93:225–234
  10. Pull ter Gunne AF, Cohen DB. Incidence, prevalence and analysis of risk factors for surgical site infection following adult spinal surgery. Spine. 2009;34:1422–1428
  11. McPhee IB, Williams RP, Swanson CE. Factors influencing wound healing after surgery for metastatic disease of the spine. Spine. 1998;23:726–733
  12. Wimmer C, Gluch H, Franzreb M, Ogon M. Predisposing factors for infection in spine surgery: a survey of 850 spinal procedures. J Spinal Disord. 1998;11:124–128
  13. Thomasen E. Vertebral osteotomy for correction of kyphosis in ankylosing spondylitis. Clin Orthop Relat Res. 1985;194:142–152
  14. Smith-Petersen MN. Osteotomy of the spine for correction of flexion deformity in rheumatoid arthritis. J Bone Joint Surg Am. 1945;2:1–11
  15. Tsiodras S, Falagas ME. Clinical assessment and medical treatment of spine infections. Clin Orthop Relat Res. 2006;444:38–50
  16. Kanafani ZA, Dakdouki GK, El-Dbouni O, et al. Surgical site infections following spinal surgery at a tertiary care center in Lebanon: incidence, microbiology, and risk factors. Scand J Infect Dis. 2006;38:589–592
  17. Rihn JA, Lee JY, Ward WT. Infection after the surgical treatment of adolescent idiopathic scoliosis: evaluation of the diagnosis, treatment, and impact on clinical outcomes. Spine. 2008;33:289–294
  18. Pulido L, Ghanem E, Joshi A, et al. Periprosthetic joint infection: the incidence, timing, and predisposing factors. Clin Orthop Relat Res. 2008;466:1710–1715
  19. Bower WF, Cheung CS, Lai RW, et al. An audit of risk factors for wound infection in patients undergoing coronary artery bypass grafting or valve replacement. Hong Kong Med J. 2008;14:371–378
  20. Banbury MK, Brizzio ME, Rajeswaran J, et al. Transfusion increases the risk of postoperative infection after cardiovascular surgery. J Am Coll Surg. 2006;202:131–138
  21. Murphy GJ, Reeves BC, Rogers CA, et al. Increased mortality, postoperative morbidity, and cost after red blood cell transfusion in patients having cardiac surgery. Circulation. 2007;116:2544–2552
  22. Tartter PI. Blood transfusion and infectious complications following colorectal cancer surgery. Br J Surg. 1988;75:789–792
  23. World-Health-Organisation. Obesity and overweight. 2006. Available at: http://www.who.int/mediacentre/factsheets/fs311/en/index.html. Accessed December 16, 2009.
  24. Andreshak TG, An HS, Hall J, Stein B. Lumbar spine surgery in the obese patient. J Spinal Disord. 1997;10:376–379
  25. Capen DA, Calderone RR, Green A. Perioperative risk factors for wound infections after lower back fusions. Orthop Clin North Am. 1996;27:83–86
  26. Massie JB, Heller JG, Abitbol JJ, et al. Postoperative posterior spinal wound infections. Clin Orthop. 1992;284:99–108
  27. Patel N, Bagan B, Vadera S, et al. Obesity and spine surgery: relation to perioperative complications. J Neurosurg Spine. 2007;6:291–297
  28. Satpathy HK, Fleming A, Frey D, et al. Maternal obesity and pregnancy. Postgrad Med. 2008;120:E01–E09
  29. Polesel J, Zucchetto A, Montella M, et al. The impact of obesity and diabetes mellitus on the risk of hepatocellular carcinoma. Ann Oncol. 2009;20:353–357
  30. Lubbeke A, Moons KG, Garavaglia G, Hoffmeyer P. Outcomes of obese and nonobese patients undergoing revision total hip arthroplasty. Arthritis Rheum. 2008;59:738–745
  31. Dowsey MM, Choong PF. Early outcomes and complications following joint arthroplasty in obese patients: a review of the published reports. ANZ J Surg. 2008;78:439–444
  32. Vaidya R, Carp J, Bartol S, et al. Lumbar spine fusion in obese and morbidly obese patients. Spine. 2009;34:495–500
  33. Ho C, Sucato DJ, Richards BS. Risk factors for the development of delayed infections following posterior spinal fusion and instrumentation in adolescent idiopathic scoliosis patients. Spine. 2007;32:2272–2277

 FDA device/drug status: not applicable.

 Authors disclosures: AFPG (grants, Prof. Michael van Vloten foundation; fellowship support, Synthes); DBC (fellowship support, DePuy Spine).

 This research was approved by the institutional review board.

PII: S1529-9430(09)01084-5

doi: 10.1016/j.spinee.2009.11.017

The Spine Journal
Volume 10, Issue 5 , Pages 410-416 , May 2010