Experience with intrawound vancomycin powder for posterior cervical fusion surgery

Joel R. Martin, Owoicho Adogwa, Christopher R. Brown, Maragatha Kuchibhatla, Carlos A. Bagley, Shivanand P. Lad, Oren N. Gottfried

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

OBJECT: Recent studies have reported that the local delivery of vancomycin powder is associated with a decrease in spinal surgical site infection. This retrospective cohort study compares posterior cervical fusion cases before and after the routine application of spinal vancomycin powder to evaluate the ability of local vancomycin powder to prevent deep wound infection after posterior cervical spinal fusion. METHODS: Posterior cervical fusion spinal surgeries performed at a single institution were reviewed from January 2011 to July 2013. Each cohort's baseline characteristics, operative data, and rates of wound infection were compared. Associations between infection and vancomycin powder, with and without propensity score adjustment for risk factors, were determined using logistic regression. RESULTS: A total of 289 patients (174 untreated and 115 treated with vancomycin powder) were included in the study. The cohorts were similar in terms of baseline and operative variables. No significant change in deep wound infection rate was seen between the control group (6.9%) and intervention group (5.2%, p = 0.563). Logistic regression, with and without propensity score adjustment, demonstrated that the use of vancomycin powder did not impact the development of surgical site infection (OR 0.743 [95% CI 0.270-2.04], p = 0.564) and (OR 0.583 [95% CI 0.198-1.718], p = 0.328), respectively. CONCLUSIONS: Within the context of an ongoing debate on the effectiveness of locally administered vancomycin powder, the authors found no significant difference in the incidence of deep wound infection rates after posterior cervical fusion surgery with routine use of locally applied vancomycin powder. Future prospective randomized series are needed to corroborate these results.

Original languageEnglish (US)
Pages (from-to)26-33
Number of pages8
JournalJournal of Neurosurgery: Spine
Volume22
Issue number1
DOIs
StatePublished - Jan 1 2015

Fingerprint

Vancomycin
Powders
Wound Infection
Surgical Wound Infection
Propensity Score
Spinal Fusion
Logistic Models
Cohort Studies
Retrospective Studies
Control Groups
Incidence
Infection

Keywords

  • Cervical fusion
  • Local anti-infective agents
  • Spinal fusion
  • Spinal stenosis
  • Treatment outcome
  • Vancomycin
  • Wound infection

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology

Cite this

Martin, J. R., Adogwa, O., Brown, C. R., Kuchibhatla, M., Bagley, C. A., Lad, S. P., & Gottfried, O. N. (2015). Experience with intrawound vancomycin powder for posterior cervical fusion surgery. Journal of Neurosurgery: Spine, 22(1), 26-33. https://doi.org/10.3171/2014.9.SPINE13826

Experience with intrawound vancomycin powder for posterior cervical fusion surgery. / Martin, Joel R.; Adogwa, Owoicho; Brown, Christopher R.; Kuchibhatla, Maragatha; Bagley, Carlos A.; Lad, Shivanand P.; Gottfried, Oren N.

In: Journal of Neurosurgery: Spine, Vol. 22, No. 1, 01.01.2015, p. 26-33.

Research output: Contribution to journalArticle

Martin, JR, Adogwa, O, Brown, CR, Kuchibhatla, M, Bagley, CA, Lad, SP & Gottfried, ON 2015, 'Experience with intrawound vancomycin powder for posterior cervical fusion surgery', Journal of Neurosurgery: Spine, vol. 22, no. 1, pp. 26-33. https://doi.org/10.3171/2014.9.SPINE13826
Martin, Joel R. ; Adogwa, Owoicho ; Brown, Christopher R. ; Kuchibhatla, Maragatha ; Bagley, Carlos A. ; Lad, Shivanand P. ; Gottfried, Oren N. / Experience with intrawound vancomycin powder for posterior cervical fusion surgery. In: Journal of Neurosurgery: Spine. 2015 ; Vol. 22, No. 1. pp. 26-33.
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abstract = "OBJECT: Recent studies have reported that the local delivery of vancomycin powder is associated with a decrease in spinal surgical site infection. This retrospective cohort study compares posterior cervical fusion cases before and after the routine application of spinal vancomycin powder to evaluate the ability of local vancomycin powder to prevent deep wound infection after posterior cervical spinal fusion. METHODS: Posterior cervical fusion spinal surgeries performed at a single institution were reviewed from January 2011 to July 2013. Each cohort's baseline characteristics, operative data, and rates of wound infection were compared. Associations between infection and vancomycin powder, with and without propensity score adjustment for risk factors, were determined using logistic regression. RESULTS: A total of 289 patients (174 untreated and 115 treated with vancomycin powder) were included in the study. The cohorts were similar in terms of baseline and operative variables. No significant change in deep wound infection rate was seen between the control group (6.9{\%}) and intervention group (5.2{\%}, p = 0.563). Logistic regression, with and without propensity score adjustment, demonstrated that the use of vancomycin powder did not impact the development of surgical site infection (OR 0.743 [95{\%} CI 0.270-2.04], p = 0.564) and (OR 0.583 [95{\%} CI 0.198-1.718], p = 0.328), respectively. CONCLUSIONS: Within the context of an ongoing debate on the effectiveness of locally administered vancomycin powder, the authors found no significant difference in the incidence of deep wound infection rates after posterior cervical fusion surgery with routine use of locally applied vancomycin powder. Future prospective randomized series are needed to corroborate these results.",
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