title: Prevalence of Allograft Contamination During Intraoperative Processing for Spinal Deformity Correction Surgery.
abstract: METHODS
  Prospective study.
  
  
  OBJECTIVE
  To prospectively evaluate bone allografts during spinal fusion surgery for 1) the rate of contamination as a result of perioperative preparation, and 2) the types of bacterial organisms that may be transmitted through the contaminated bone allograft.
  
  
  BACKGROUND
  Bone allografts are routinely used to enhance spinal arthrodesis procedures. Ready availability and lack of donor site morbidity make them valuable alternatives to iliac crest bone grafts. Reports of disease transmission of such organisms as hepatitis C, the human immunodeficiency virus, and a variety of bacterial pathogens through allograft bone implants raise concerns for patient and practitioner safety.
  
  
  METHODS
  Our study population consisted of 50 consecutive (20 male and 30 female) patients (mean age at surgery, 15 years; range, 3-51 years) undergoing spinal deformity correction from May 2010 through October 2010, by 1 surgeon at 1 institution. The mean operative time was 297 minutes (range, 81-444 minutes), and the most commonly fused spinal levels were T5 to L4. During the procedure, the researchers prospectively obtained intraoperative microbial culture swabs from a container with freeze-dried allograft and from an empty identical control container. Aerobic and anaerobic bacterial culture growth was assessed for 7 days postoperatively. Each patient was observed for 6 weeks after surgery to ascertain any evidence of surgical-site infection.
  
  
  RESULTS
  Microbial cultures showed bacterial growth in 4 cases: 1 allograft specimen (day 4, very light Staphylococcus aureus) and 3 control specimens (day 3, very light Enterococcus; day 4, very light S aureus; and day 6, Propionibacterium acnes). No patient showed signs of infection in the perioperative or 6-week postoperative period.
  
  
  CONCLUSIONS
  Intraoperative allograft preparation is not a major source of bone allograft contamination during spinal surgery.
authors.affiliation: Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline Street, Baltimore, MD 21287, USA.
authors.forename: Hamid
authors.initials: H
authors.lastname: Hassanzadeh
authors.affiliation: Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline Street, Baltimore, MD 21287, USA.
authors.forename: Amit
authors.initials: A
authors.lastname: Jain
authors.affiliation: Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline Street, Baltimore, MD 21287, USA.
authors.forename: Khaled M
authors.initials: KM
authors.lastname: Kebaish
authors.affiliation: Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline Street, Baltimore, MD 21287, USA.
authors.forename: Philip R
authors.initials: PR
authors.lastname: Neubauer
authors.affiliation: Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline Street, Baltimore, MD 21287, USA.
authors.forename: Addisu
authors.initials: A
authors.lastname: Mesfin
authors.affiliation: Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline Street, Baltimore, MD 21287, USA.
authors.forename: Benjamin E
authors.initials: BE
authors.lastname: Stein
authors.affiliation: Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline Street, Baltimore, MD 21287, USA. Electronic address: ehenze1@jhmi.edu.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Ain
keywords: Allograft; Bone graft; Complication; Contamination; Deformity; Infection