The Difference in Surgical Site Infection Rates Between Open and Minimally Invasive Spine Surgery for Degenerative Lumbar Pathology: A Retrospective Single Center Experience of 1442 Cases.
Citation: Operative Neurosurgery. 16(6):750-755, 2019 06 01.PMID: 30107559Institution: MedStar Washington Hospital CenterDepartment: NeurosurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Decompression, Surgical/mt [Methods] | *Lumbar Vertebrae/su [Surgery] | *Minimally Invasive Surgical Procedures/mt [Methods] | *Neurosurgical Procedures/mt [Methods] | *Spinal Fusion/mt [Methods] | *Surgical Wound Infection/ep [Epidemiology] | Adolescent | Adult | Aged | Aged, 80 and over | Female | Humans | Intervertebral Disc Degeneration/su [Surgery] | Male | Middle Aged | Retrospective Studies | Scoliosis/su [Surgery] | Spinal Stenosis/su [Surgery] | Spondylolisthesis/su [Surgery] | Young AdultYear: 2019ISSN:- 2332-4252
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 30107559 | Available | 30107559 |
BACKGROUND: Surgical site infection (SSI) in spinal surgery contributes to significant morbidity and healthcare resource utilization. Few studies have directly compared the rate of minimally invasive surgery (MIS) SSI with open surgery.
CONCLUSION: Our study demonstrates a significant 7-fold reduction in SSIs when comparing MIS with open surgery. This significance was also demonstrated with a 10-fold reduction for procedures involving decompression alone. Procedures that require fusion as well as decompression showed a trend towards a decreased infection rate that did not reach clinical significance. Copyright (c) 2018 by the Congress of Neurological Surgeons.
METHODS: A single-center, retrospective review of a prospectively collected database was queried from January 2013 to 2016 for adult patients who underwent lumbar decompression and/or instrumented fusion for which the surgical indication involved degenerative disease. The SSI rate was determined for all procedures as well as in the open and minimally invasive groups. Risk factors associated with SSI were also reviewed for each patient.
OBJECTIVE: To investigate whether MIS techniques had a lower SSI rate in degenerative lumbar procedures as compared with traditional open techniques.
RESULTS: A total of 1442 lumbar spinal procedures were performed during this time period. Of these, there were 961 MIS and 481 open (67% vs 33%, respectively). The overall SSI rate was 1.5% (21/1442). The surgical site infection rate for MIS was less than open techniques (0.5% vs 3.3%; P = .0003). For decompression only, the infection rate for MIS and open was 0.4% vs 3.9% (P = .04), and for decompression with fusion it was 0.7% vs 2.6%, respectively (P = .68).
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