Surgical associated factors — preoperative radiation/postoperative blood transfusion , combined anterior/posterior approach , surgical invasiveness , or levels of instrumentation were associated with increased SSI .
There is mixed evidence of age , duration of surgery , surgical team , intraoperative blood loss , dural tear , and urinary tract infection/urinary catheter in association with SSI .
Conclusion : SSIs are associated with many risk factors that can be patient or surgically related .
Objective : To perform a review of SSI risk factors and more specifically , categorize them into patient and surgical factors .
Does Minimally Invasive Surgery Have a Lower Risk of Surgical Site Infections Compared With Open Spinal Surgery?
Background Surgical site infection ( SSI ) ranges from 1.9 % to 5.5 % in most large series . Minimally invasive surgery ( MIS ) has been postulated to reduce SSI rates . Questions / purpose s(1 ) Is MIS associated with a lower incidence of SSI compared with open spinal surgery ? ( 2 ) Are there other independent risk factors associated with SSI ? ( 3 ) What bacteria are most common in spinal SSI ? Methods Medical records of 2299 patients who underwent transforaminal lumbar interbody fusion , laminectomy , or discectomy  were analyzed and selected for a nested case-control analysis . Twenty-seven cases with SSI were matched with 162 control subjects without SSI stratified based on procedure performed within 28 days of the case ’s date of surgery . Patients were identified from an institutional data base at a tertiary care hospital .  MIS involved spinal procedures performed through a tubular retractor system . Univariate and multivariate analyses were performed . Results Patients undergoing open spinal surgery were 5.77 times more likely to develop SSI compared with MIS approaches ( odds ratio [ OR ] , 5.77 ; 95 % confidence interval [ CI ] , 1.0–32.7 ; p = 0.048 ) . Also , from the multivariate regression model , diabetes ( OR , 4.7 ; 95 % CI , 1.3–17.0 ; p = 0.018 ) , number of levels operated on ( OR , 3.5 ; 95 % CI , 1.6–7.5 ; p = 0.001 ) , and body mass index ( OR , 1.2 ; 95 % CI , 1.0–1.3 ; p = 0.010 ) were predictive of an increased risk in SSI . Staphylococcus aureus was most frequently identified , being present in 12 of 21 ( 52.4 % ) patients in whom positive cultures were obtained . Four of the 12 patients had methicillin-resistant S aureus infection . Conclusions In our series , MIS has a lower incidence of SSI . The risk factors predictive of SSI should be further evaluated in well- design ed prospect i ve trials . Level of Evidence Level III , therapeutic study . See Guidelines for Authors for a complete description of levels of evidence
Surgical associated factors — preoperative radiation/postoperative blood transfusion , combined anterior/posterior approach , surgical invasiveness , or levels of instrumentation were associated with increased SSI .
There is mixed evidence of age , duration of surgery , surgical team , intraoperative blood loss , dural tear , and urinary tract infection/urinary catheter in association with SSI .
Conclusion : SSIs are associated with many risk factors that can be patient or surgically related .
Objective : To perform a review of SSI risk factors and more specifically , categorize them into patient and surgical factors .