Prevalence

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Spinal Infection and Complications

III.C.1.0

Lead Author(s):

Sigurd H. Berven, MD

Matthew D. Hepler, MD

Supporting Author(s):

Sylvia I. Watkins-Castillo, PhD

The most common adverse events associated with spine surgery include neurologic injury, infection, re-operation, medical complications, and dural tear.1 Of these, infection is the most frequently studied and reported both in the literature and within healthcare delivery organizations. Infection rates for lumbar spine surgery are frequently reported between 3% to 5% in many studies, but have a wide range depending on the type of procedure performed. Studies have reported an infection rate of 1% or less in single-level micro-discectomy cases (a small decompression procedure for disc herniation with sciatic pain); 3% to 7% in instrumented fusion cases (a stabilization procedure usually involving one to two levels for back pain or instability); 7% to 10% in adult deformity reconstruction (procedures to realign the spine in patients with scoliosis/kyphosis); and greater than 20% in neuromuscular deformity cases.1^,2^,3^,4

In 2011, a total 370,000 discectomy and 498,700 fusion/refusion procedures were performed. Based on conservative estimated infection rates of 1% and 5%, for discectomy and fusion/refusion, respectively, we can estimate there were 28,600 postoperative spine infections. It is unknown what proportion of spinal infection diagnosis-related health care visits this represents. (Reference Table 2.14 PDF CSV and Table 2.19 PDF CSV)

1. a. b. Mirza SK, Deyo RA, Heagerty PJ, et al: Towards standardized measurement of adverse events in spine surgery: Conceptual model and pilot evaluation. BMC Musc. Disorder 2006;7:53.
2. Bassewitz HL, Fischgrund JS, Herkowitz HN: Postoperative spine infections. Semin Spine Surg 2000;12:203-211.
3. Nandyala SV, Marquez-Lara A, Fineberg SJ, et al: Comparison of perioperative outcomes and cost of spinal fusion for cervical trauma: weekday versus weekend admissions. Spine 2013;38(25)2178-83
4. Sponseller PD, Laporte DM, Hungerford MW et al: Deep wound infections after neuromuscular scoliosis surgery: multicenter study of risk factors and treatment outcomes. Spine 2000;25:2461-2466.