POSTOPERATIVE INFECTIONS OF THE LUMBAR SPINE: PRESENTATION AND MANAGEMENT

Authors

  • MI KHAN Department of Neurosurgery, Khyber Teaching Hospital, Peshawar, Pakistan
  • A MUNIR Department of Neurosurgery, Khyber Teaching Hospital, Peshawar, Pakistan
  • S ULLAH Department of Neurosurgery, Khyber Teaching Hospital, Peshawar, Pakistan
  • S MEHBOOB Department of Neurosurgery, Khyber Teaching Hospital, Peshawar, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2024i1.730

Keywords:

Lumbar Spine, Postoperative Infections, Retrospective Study, Epidemiology, Clinical Presentation, Management, Microbiology, Outcomes

Abstract

: Postoperative infections of the lumbar spine pose significant challenges in clinical management and patient outcomes. Despite advances in surgical techniques and perioperative care, these infections continue to occur, leading to increased morbidity and healthcare costs. Understanding the presentation and management of these infections is crucial for optimizing patient care and outcomes. The objective of the study is to assess the prevalence of spinal surgeries, comorbidities, diagnostic modalities, treatment approaches, and their correlations in managing surgical site infections among patients at Khyber Teaching Hospital. Medical records of 800 patients who underwent lumbar spine surgery at Khyber Teaching Hospital from 2020 to 2022 were retrospectively reviewed. Data regarding patient demographics, surgical details, infection characteristics, microbiological findings, treatment modalities, and outcomes were collected and analyzed. Descriptive statistics were used to summarize the findings, and inferential statistics were employed to explore associations between variables. The study comprised 800 spinal surgery patients at Khyber Teaching Hospital, with a mean age of 58 ± (12.3 SD) years. Laminectomy was the most common procedure (43.75%), followed by discectomy (22.5%). Clinical inspection was predominantly used for SSI diagnosis (95.6%), and post-surgical measures included debridement, antibiotics and cultures. Correlation analysis revealed varying associations between surgeries and post-operative symptoms. The Treatment outcomes showed high-resolution rates, with surgical debridement demonstrating the highest efficacy. This study reveals laminectomy as the most common procedure. As laminectomy was the most common procedure done, that’s why SSI was more common in these procedures. Key diagnostic methods for detecting surgical site infections (SSI) was clinical examination of wound status and pus discharge. The study revealed that patients with early surgical debridement had the best outcome in early resolution of infection and wound healing. Thus, Correlation analysis between surgeries and symptoms guides clinical decisions, with surgical debridement followed by antibiotics showing the highest efficacy in resolving infections. These findings stress the need for tailored patient care strategies to enhance outcomes and reduce complications in spinal surgery.

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References

Adityanjee, S. M., Munshi, K., Anitha, M., Gondha, C., Sutliff, R., Parsadanian, A., Mwangi, S., Sitaraman, S., Srinivasan, S., and Anthony, I. (2006). Neuromuscular diseases: nerve. Neurology 66, 867-873.

Anderson, P. A., Savage, J. W., Vaccaro, A. R., Radcliff, K., Arnold, P. M., Lawrence, B. D., and Shamji, M. F. (2017). Prevention of surgical site infection in spine surgery. Neurosurgery 80, S114-S123.

Atesok, K., Papavassiliou, E., Heffernan, M. J., Tunmire, D., Sitnikov, I., Tanaka, N., Rajaram, S., Pittman, J., Gokaslan, Z. L., and Vaccaro, A. (2020). Current strategies in prevention of postoperative infections in spine surgery. Global spine journal 10, 183-194.

Baniasadi, T., Hassaniazad, M., Rostam Niakan Kalhori, S., Shahi, M., and Ghazisaeedi, M. (2023). Developing a mobile health application for wound telemonitoring: a pilot study on abdominal surgeries post-discharge care. BMC Medical Informatics and Decision Making 23, 1-13.

Blood, A. G., Sandoval, M. F., Burger, E., and Halverson-Carpenter, K. (2017). Risk and protective factors associated with surgical infections among spine patients. Surgical infections 18, 234-249.

Bucataru, A., Balasoiu, M., Ghenea, A. E., Zlatian, O. M., Vulcanescu, D. D., Horhat, F. G., Bagiu, I. C., Sorop, V. B., Sorop, M. I., and Oprisoni, A. (2023). Factors Contributing to Surgical Site Infections: A Comprehensive Systematic Review of Etiology and Risk Factors. Clinics and Practice 14, 52-68.

Chang, Y., Bhandari, M., Zhu, K. L., Mirza, R. D., Ren, M., Kennedy, S. A., Negm, A., Bhatnagar, N., Naji, F. N., and Milovanovic, L. (2019). Antibiotic prophylaxis in the management of open fractures: a systematic survey of current practice and recommendations. JBJS reviews 7, e1.

Chestovich, P. J., Browder, T. D., Morrissey, S. L., Fraser, D. R., Ingalls, N. K., and Fildes, J. J. (2015). Minimally invasive is maximally effective: diagnostic and therapeutic laparoscopy for penetrating abdominal injuries. Journal of Trauma and Acute Care Surgery 78, 1076-1085.

Di Saverio, S., Podda, M., De Simone, B., Ceresoli, M., Augustin, G., Gori, A., Boermeester, M., Sartelli, M., Coccolini, F., and Tarasconi, A. (2020). Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines. World journal of emergency surgery 15, 1-42.

Edmiston Jr, C. E., Spencer, M., and Leaper, D. (2018). Antiseptic irrigation as an effective interventional strategy for reducing the risk of surgical site infections. Surgical infections 19, 774-780.

Hanrahan, C. J., and Shah, L. M. (2011). MRI of spinal bone marrow: part 2, T1-weighted imaging-based differential diagnosis. American Journal of Roentgenology 197, 1309-1321.

Hegde, V., Meredith, D. S., Kepler, C. K., and Huang, R. C. (2012). Management of postoperative spinal infections. World Journal of Orthopedics 3, 182.

Huang, M., Manzano, G. R., and Levi, A. D. (2021). Meningioma. Tumors of the Spinal Canal, 39-51.

Katarincic, J. A., Fantry, A., DePasse, J. M., and Feller, R. (2018). Local modalities for preventing surgical site infections: an evidence-based review. JAAOS-Journal of the American Academy of Orthopaedic Surgeons 26, 14-25.

Li, Z., Liu, P., Zhang, C., Xu, G., Zhang, Y., Chang, Y., Liu, M., and Hou, S. (2019). Incidence, prevalence, and analysis of risk factors for surgical site infection after lumbar fusion surgery:≥ 2-year follow-up retrospective study. World neurosurgery 131, e460-e467.

Lim, S., Yoo, Y.-M., and Kim, K.-H. (2023). No more tears from surgical site infections in interventional pain management. The Korean Journal of Pain 36, 11-50.

Long, D. R., Alverdy, J. C., and Vavilala, M. S. (2022). Emerging paradigms in the prevention of surgical site infection: the patient microbiome and antimicrobial resistance. Anesthesiology 137, 252-262.

Müller, D., Kaiser, D., Sairanen, K., Studhalter, T., and Uçkay, İ. (2019). Antimicrobial prophylaxis for the prevention of surgical site infections in orthopaedic oncology-a narrative review of current concepts. Journal of bone and joint infection 4, 254-263.

Parker, S. L., McGirt, M. J., Bekelis, K., Holland, C. M., Davies, J., Devin, C. J., Atkins, T., Knightly, J., Groman, R., and Zyung, I. (2015). The national neurosurgery quality and outcomes database qualified clinical data registry: 2015 measure specifications and rationale. Neurosurgical focus 39, E4.

Patel, T. R., and Chiang, V. L. (2014). Laser interstitial thermal therapy for treatment of post-radiosurgery tumor recurrence and radiation necrosis. Photonics & Lasers in Medicine 3, 95-105.

Rivano, M., Scientific co-chairmen, L., Freeman, M., Westergren, H., and Malmström, E.-M. (2011). Fifth International Whiplash Trauma Congress Lund, Sweden August 24–28, 2011. J Rehabil Med 50, 1-36.

ROSIN, A. Progressione miopica: l'effetto dell'utilizzo dei dispositivi digitali in età pediatrica.

Spina, N. T., Aleem, I. S., Nassr, A., and Lawrence, B. D. (2018). Surgical site infections in spine surgery: preoperative prevention strategies to minimize risk. Global spine journal 8, 31S-36S.

Tomsic, I., Heinze, N. R., Chaberny, I. F., Krauth, C., Schock, B., and von Lengerke, T. (2020). Implementation interventions in preventing surgical site infections in abdominal surgery: a systematic review. BMC health services research 20, 1-21.

Wang, Y., Xu, C., Zhang, R., Chen, Y., Shen, Y., Hu, F., Liu, D., Lu, J., Guo, Y., and Xia, X. (2020). Changes in colistin resistance and mcr-1 abundance in Escherichia coli of animal and human origins following the ban of colistin-positive additives in China: an epidemiological comparative study. The Lancet Infectious Diseases 20, 1161-1171.

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Published

2024-03-02

How to Cite

KHAN , M., MUNIR , A., ULLAH , S., & MEHBOOB , S. (2024). POSTOPERATIVE INFECTIONS OF THE LUMBAR SPINE: PRESENTATION AND MANAGEMENT. Biological and Clinical Sciences Research Journal, 2024(1), 730. https://doi.org/10.54112/bcsrj.v2024i1.730

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