ANALYSIS OF EARLY INFECTIOUS COMPLICATIONS IN PATIENTS AFTER SPINAL SURGERY

Objective. To assess the incidence of early infectious complications after spine surgery and to study the structure of risk factors in patients with surgical site infections.

Material and Methods. Early infectious complications after spine surgery were evaluated in 77 patients. The underlying pathology, comorbidities and surgical factors that caused the infection were analyzed.

Results. Over the 10-year observation period, the frequency of early postoperative infectious complications was 1.4 %. The main microorganisms causing infectious complication after spine surgery are methicillin-resistant S. aureus and S. epidermidis strains. The study revealed a direct correlation between obesity and surgical site infections. Such surgical factors as metal fixation, duration of operation and spinal fusion also contributed to the development of the inflammatory process in the early postoperative period.

Conclusion. Difficulties with the arrest of the infectious process require the development of methods for predicting the risk of complications and measures to reduce it. For this it is necessary to conduct comparative analysis of the frequency of occurrence of various risk factors in groups of patients with surgical site infections and of those with normal course of the postoperative period. 

1. Божкова С.А., Тихилов Р.М., Краснова М.В., Рукина А.Н. Ортопедическая имплантат-ассоциированная инфекция: ведущие возбудители, локальная резистентность и рекомендации по антибактериальной терапии. Травматология и ортопедия России. 2013. № 4. С. 5-15.

2. Тиходеев С.А., Вишневский А.А. Неспецифический остеомиелит позвоночника. СПб., 2004.

3. Ahn DK, Park HS, Choi DJ, Kim TW, Chun TH, Yang JH, Kim DG. The difference of surgical site infection according to the methods of lumbar fusion surgery. J Spinal Disord Tech. 2012;25:E230-E234. DOI: 10.1097/BSD.0b013e31825c6f7b.

4. Brady RA, Calhoun JH, Leid JG, Shirtliff ME. Infections of orthopedic implants and device. In: Biofilms and Device-Related Infections, Shirtliff ME, Leid JG. eds. NY: Springer, 2009:15-56.

5. Calderone RR, Capen DA. Spinal infections. Orthop Clin North Am. 1996;27:1-212.

6. Cammisa FP Jr, Girardi FP, Sangani PK, Parvataneni HK, Cadag S, Sandhu HS. Incidental durotomy in spine surgery. Spine. 2000;25:2663-2667.

7. Hegde V, Meredith DS, Kepler CK, Huang RC. Management of postoperative spinal infections. World J Orthop. 2012;3:182-189. DOI: 10.5312/wjo.v3.i11.182.

8. Koutsoumbelis S, Hughes AP, Girardi FP, Cammisa FP Jr, Finerty EA, Nguyen JT, Gausden E, Sama AA. Risk factors for postoperative infection following posterior lumbar instrumented arthrodesis. J Bone Joint Surg Am. 2011;93:1627-1633. DOI: 10.2106/JBJS.J.00039.

9. Massie JB, Heller JG, Abitbol JJ, McPherson D, Garfin SR. Postoperative posterior spinal wound infection. Clin Orthop Relat Res. 1992;(284):99-108.

10. National Nosocomial Infections Surveillance (NNIS) System Report, Data Summary from January 1992 - June 2001, issued August 2001. Am J Infect Control. 2001;29:404-421. DOI: 10.1067/mic.2001.119952.

11. Olsen MA, Nepple JJ, Riew KD, Lenke LG, Bridwell KH, Mayfield J, Fraser VJ. Risk factors for surgical site infection following orthopaedic spinal operation. J Bone Joint Surg Am. 2008;90:62-69. DOI: 10.2106/JBJS.F.01515.

12. O’Toole JE, Eichholz KM, Fessler RG. Surgical site infection rates after minimally invasive spinal surgery. J Neurosurg Spine. 2009;11:471-476. DOI: 10.3171/2009.5.SPINE08633.

13. Pull ter Gunne AF, Cohen DB. Incidence, prevalence and analysis of factors for surgical site infection following adult spinal surgery. Spine. 2009;34:1422-1428. DOI: 10.1097/BRS.0b013e3181a03013.

14. Weinstein MA, McCabe JP, Cammisa FP Jr. Postoperative spinal wound infection: a review of 2,391 consecutive index procedures. J Spinal Disord. 2000;13:422-426. DOI: 10.1097/00002517-200010000-00009.

15. 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. DOI: 10.1097/00002517-199804000-00006.

16. Zimmerli W, Trampuz A. Biomaterial-associated infection: a percpective from the clinic. In: Biomaterials Associated Infection: Immunological Aspects and Antimicrobial Strategies, ed by Moriarty TF, Zaat SA, Busscher HJ. NY: Springer, London: Heidelberg Dordrecht. 2013:3-24.