Samer Habiba1, Øystein P Nygaard2,3, Jens I Brox2,4, Christian Hellum2,4, Ivar M Austevoll2,5, Tore K Solberg2,6,7. 1. Department of Neurosurgery, Haukeland University Hospital, Bergen, Norway. samer.habiba@helse-bergen.no. 2. Norwegian Registry for Spine Surgery (NORspine), Northern Norway Regional Health Authority, Bergen, Norway. 3. Department of Neurosurgery, St. Olavs Hospital and Institute of Neuroscience Medical Faculty Norwegian University of Science and Technology (NTNU), Trondheim, Norway. 4. Department of Orthopaedics, Oslo University Hospital, University of Oslo, Oslo, Norway. 5. Department of Orthopaedics, Haukeland University Hospital, Bergen, Norway. 6. Department of Neurosurgery, University Hospital of North Norway, Tromsø, Norway. 7. The Department of Clinical Medicine, University of Tromsø The Arctic University of Norway, Tromsø, Norway.
Abstract
BACKGROUND: There are no previous studies evaluating risk factors for surgical site infections (SSIs) and the effectiveness of prophylactic antibiotic treatment (PAT), specifically for patients operated on for lumbar disc herniation. METHOD: This observational multicentre study comprises a cohort of 1,772 consecutive patients operated on for lumbar disc herniation without laminectomy or fusion at 23 different surgical units in Norway. The patients were interviewed about SSIs according to a standardised questionnaire at 3 months' follow-up. RESULTS: Three months after surgery, 2.3% of the patients had an SSI. Only no PAT (OR = 5.3, 95% CI = 2.2-12.7, p< 0.001) and longer duration of surgery than the mean time (68 min) (OR = 2.8, 95% CI = 1.2-6.6, p = 0.02) were identified as independent risk factors for SSI. Numbers needed to have PAT to avoid one SSI was 43. CONCLUSIONS: In summary, this study clearly lends support to the use of PAT in surgery for lumbar disc herniation. Senior surgeons assisting inexperienced colleagues to avoid prolonged duration of surgery could also reduce the occurrence of SSI.
BACKGROUND: There are no previous studies evaluating risk factors for surgical site infections (SSIs) and the effectiveness of prophylactic antibiotic treatment (PAT), specifically for patients operated on for lumbar disc herniation. METHOD: This observational multicentre study comprises a cohort of 1,772 consecutive patients operated on for lumbar disc herniation without laminectomy or fusion at 23 different surgical units in Norway. The patients were interviewed about SSIs according to a standardised questionnaire at 3 months' follow-up. RESULTS: Three months after surgery, 2.3% of the patients had an SSI. Only no PAT (OR = 5.3, 95% CI = 2.2-12.7, p< 0.001) and longer duration of surgery than the mean time (68 min) (OR = 2.8, 95% CI = 1.2-6.6, p = 0.02) were identified as independent risk factors for SSI. Numbers needed to have PAT to avoid one SSI was 43. CONCLUSIONS: In summary, this study clearly lends support to the use of PAT in surgery for lumbar disc herniation. Senior surgeons assisting inexperienced colleagues to avoid prolonged duration of surgery could also reduce the occurrence of SSI.