Low postoperative infection rates with instrumented lumbar fusion.
BACKGROUND
Studies have shown postoperative infection rates increase with the use of internal instrumentation. It is believed that longer operative times, prolonged retraction, instrumentation, and bone grafting lead to a higher risk of infection.


METHODS
We retrospectively reviewed 126 consecutive instrumented lumbar fusions. All had bone graft. The infection rate was statistically compared with previously reported values.


RESULTS
Our infection rate (0.8%) was lower than the combined data from the literature (2.8%), though not significantly different. No significant differences were noted regarding patient or surgical factors.


CONCLUSIONS
This review showed that low rates of postoperative infection can be achieved despite patient or surgical factors. We believe that conforming to strict techniques, including copious irrigation and debridement, and having experienced operating room personnel and short operating times will reduce the incidence of postoperative infections.
Hodges
S D
SD
Chattanooga Orthopaedic Group, Foundation for Research, Tenn 37404, USA.
Humphreys
S C
SC
Eck
J C
JC
Covington
L A
LA
Kurzynske
N G
NG
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016025:Bone Transplantation / Q000009:adverse effects; D002437:Cefazolin / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D002648:Child; D003646:Debridement; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D005839:Gentamicins / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D016268:Internal Fixators / Q000009:adverse effects; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013123:Spinal Fusion / Q000009:adverse effects / Q000295:instrumentation*; D013530:Surgical Wound Infection / Q000209:etiology*; D007507:Therapeutic Irrigation; D013997:Time Factors; D014640:Vancomycin / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D005839:Gentamicins; D014640:Vancomycin; D002437:Cefazolin