Local Prophylactic Teicoplanin Effect on Spinal Fusion Surgery: A Comparative Retrospective Study


ELMADAĞ N. M., KARA D., Pulatkan A., UÇAN V., Hacer Cesme D., Aliyev O., ...More

Journal of Neurological Surgery, Part A: Central European Neurosurgery, 2022 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Publication Date: 2022
  • Doi Number: 10.1055/a-2103-7519
  • Journal Name: Journal of Neurological Surgery, Part A: Central European Neurosurgery
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, EMBASE, MEDLINE
  • Keywords: fusion mass, fusion mass, prophylactic antibiotics, prophylactic antibiotics, spinal fusion surgery, spinal fusion surgery, Surgical site infections, Surgical site infections, teicoplanin, teicoplanin, vancomycin, vancomycin
  • Bezmialem Vakıf University Affiliated: Yes

Abstract

Background: Surgical site infection (SSI) is one of the severe complications of spinal fusion surgery that leads to increased morbidity and mortality rates. Prophylactic antibiotic usage is one of the methods that reduce the SSI possibility in this procedure. To determine the effect of local subfascial teicoplanin and compare it to vancomycin on surgical outcomes in patients who underwent decompression with posterior instrumentation (DPI) for lumbar spinal stenosis (LSS). Patients and methods: Medical charts of patients with LSS who received DPI and met the study criteria were divided into three groups: the teicoplanin group included patients who underwent DPI with local teicoplanin before closure, the vancomycin group, included patients who underwent DPI with local vancomycin, and the control group included patients who underwent DPI without any local prophylactic antibiotics. Results: A total of 101 patients were included in the study. No significant differences were found among groups regarding demographics, follow-up, and clinical and functional outcomes. No significant differences were observed among groups regarding postoperative improvements in SF-36-MCS, SF-36-PCS, Oswestry disability index, and VAS (p>0.05). In the teicoplanin and vancomycin groups, the SSI rate was lower without statistical significance (2/35, 1/34, and 5/32, respectively, p=0.136); however, the postoperative fusion volume was significantly higher in the teicoplanin group when compared to other groups (3.35±1.08 cm3, 2.68±1.17 cm3, and 2.65±1.28 cm3, respectively, p=0.007). Conclusions: Although its cost is relatively higher, teicoplanin was a good alternative for vancomycin in preventing SSIs with a higher fusion rate, but no superiority was observed regarding other outcomes. Background: Surgical site infection (SSI) is one of the severe complications of spinal fusion surgery that leads to increased morbidity and mortality rates. Prophylactic antibiotic usage is one of the methods that reduce the SSI possibility in this procedure. To determine the effect of local subfascial teicoplanin and compare it to vancomycin on surgical outcomes in patients who underwent decompression with posterior instrumentation (DPI) for lumbar spinal stenosis (LSS). Patients and methods: Medical charts of patients with LSS who received DPI and met the study criteria were divided into three groups: the teicoplanin group included patients who underwent DPI with local teicoplanin before closure, the vancomycin group, included patients who underwent DPI with local vancomycin, and the control group included patients who underwent DPI without any local prophylactic antibiotics. Results: A total of 101 patients were included in the study. No significant differences were found among groups regarding demographics, follow-up, and clinical and functional outcomes. No significant differences were observed among groups regarding postoperative improvements in SF-36-MCS, SF-36-PCS, Oswestry disability index, and VAS (p>0.05). In the teicoplanin and vancomycin groups, the SSI rate was lower without statistical significance (2/35, 1/34, and 5/32, respectively, p=0.136); however, the postoperative fusion volume was significantly higher in the teicoplanin group when compared to other groups (3.35±1.08 cm3, 2.68±1.17 cm3, and 2.65±1.28 cm3, respectively, p=0.007). Conclusions: Although its cost is relatively higher, teicoplanin was a good alternative for vancomycin in preventing SSIs with a higher fusion rate, but no superiority was observed regarding other outcomes.