Introduction: Surgical site infections in lumbar spine surgery result in significant morbidity, extended hospital stay and significant hospital cost. Minimally invasive spine techniques require smaller incisions and less dissection minimizing necessary tissue exposure. These inherent properties of minimally invasive spine procedures should result in a low incidence of surgical site infections. We present our experience with surgical site infections in minimally invasive spine procedures.
Methods: Minimally invasive spine procedures performed over an 8 year period were gathered. These were categorized according to the approach and nature of the procedure (decompression alone versus fusion). These cases were retrospectively reviewed to evaluate the rate of surgical site infections. Incidents of surgical site infections were further investigated and details presented.
Results: 970 minimally invasive spine procedures were performed from 2004-2012. 542 (56%) were decompressive procedures and 428 were fusion procedures. 196 transforaminal lumbar interbody fusions, 230 lateral lumbar interbody fusions and 2 axial lumbar interbody fusions were performed. 2 of the 970 (0.2%) cases were complicated by a surgical site infections. One surgical site infection was a stitch abscess which occurred in a patient following a minimally invasive lumbar discectomy. This was successfully treated with oral antibiotics. The other infectious complication was an intra-abdominal fistula following a later lumbar interbody fusion in a patient with history of gastric bypass and diabetes. This required surgical intervention by our general surgery colleagues and long-term IV antibiotics.
Conclusions: Minimally invasive lumbar spine surgery minimizes exposure and results in a very low incidence of surgical site infections. The use of minimally invasive techniques should result in significantly decreased morbidity and reduced hospital costs.
Patient Care: Potentially lead to decrease in surgical site infections patients undergoing spine surgery
Learning Objectives: Understand the rate of surgical site infections in minimally invasive lumbar spine surgery