title: Postoperative culture positive surgical site infections after the use of irradiated allograft, nonirradiated allograft, or autograft for spinal fusion.
abstract: METHODS
  Retrospective chart review.
  
  
  OBJECTIVE
  We report the rate of postoperative infection at our institution following the use of irradiated allograft, nonirradiated allograft, or autograft for spinal fusion procedures.
  
  
  BACKGROUND
  Infection after a spinal fusion procedure is a devastating complication. It has not been defined whether spine bone graft preparation has any correlation with postoperative infection in spinal fusion procedures.
  
  
  METHODS
  We retrospectively identified 1435 patients who underwent spine fusion procedures with a minimum 1-year follow-up. Irradiated allograft was used in 144 patients, nonirradiated allograft was used in 441 patients, and autograft was used in 850 patients. Postoperative spinal infection was based on documented positive spine cultures at the time of re-exploration for presumed infection. Infection rates were estimated using the method of Kaplan and Meier; estimates were calculated out to 1-year postsurgery, and rates were compared using log-rank tests.
  
  
  RESULTS
  No significant difference in the rate of surgical site infection at 1 year was observed after the use of irradiated allograft (1.7%), nonirradiated allograft (3.2%), or autograft (4.3%), P = 0.51.
  
  
  CONCLUSIONS
  There is no significant difference in the rate of infection following spine fusion using irradiated allograft, nonirradiated allograft, or autograft. The selection of bone graft to aid in spinal fusion should be based on the requirements of surgical technique and availability of the desired tissue and not on a perceived association with postoperative infection.
authors.affiliation: Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA. mikhael.mark@mayo.edu
authors.forename: Mark M
authors.initials: MM
authors.lastname: Mikhael
authors.forename: Paul M
authors.initials: PM
authors.lastname: Huddleston
authors.forename: Ahmad
authors.initials: A
authors.lastname: Nassr
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016025:Bone Transplantation / Q000009:adverse effects* / Q000379:methods; D002648:Child; D002675:Child, Preschool; D004866:Equipment Contamination / Q000517:prevention & control / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008828:Microbiological Techniques / Q000379:methods; D008875:Middle Aged; D011827:Radiation; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000009:adverse effects* / Q000379:methods; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000517:prevention & control; D014182:Transplantation, Autologous / Q000009:adverse effects* / Q000379:methods; D014184:Transplantation, Homologous / Q000009:adverse effects* / Q000379:methods; D055815:Young Adult