Risk Factors Of Surgical Site Infection In Posterior Cervical Surgery

Background: The morbidity of cervical related diseases has been rising in recent years.With the constant development of surgical techniques and instruments,the cervical posterior approach has become a major surgical approach for the treatment of cervical diseases.Surgical site infection(SSI)is one of the most common complications of posterior cervical surgery.It is difficult to diagnose in the early stage and may lead to severe consequences such as wound dehiscence and central nervous system infection.However,there is still a lack of strong clinical evidence for many risk factors for SSI in posterior cervical surgery.Therefore,the purpose of this study was to research the risk factors for surgical site infection in posterior cervical surgery.Methods: With retrospective method,this study analyzed the patients who underwent posterior cervical surgery for the treatment of cervical spondylotic myelopathy,ossification of cervical posterior longitudinal ligament(OPLL),cervical fracture,cervical intraspinal tumor and other diseases in Department of Spine,Zhongda Hospital Affiliated to Southeast University in the period from Jun.2013 to Apr.2019.17 cases of postoperative infection were screened out.Randomly selected 68 cases from uninfected patients with a ratio of 1:4 as the control group.Gender,age,body mass index(BMI),nutritional status(serum albumin,serum total cholesterol,lymphocyte count),combined diabetes and hypertension,intraoperative blood loss,operative time,surgical incision length,postoperative drainage volume and drainage tube indwelling time of the two groups of patients were collected.After univariate analysis,the factors with statistical significance were filtered out and included in Logistic regression equation for multivariate regression analysis.Results: A total of 235 cases were collected,in which 17 cases were in the infected group and 218cases were in the non-infected group.The incidence of infection was 7.23%.For the infection group,there were 12 male patients and 5 female patients,with an average age of 59.66±11.23 years and for the non-infected group,there were 165 male patients and 53 female patients,with an average age of60.16±11.4 years.Gender,age,nutritional status,combined hypertension,intraoperative blood loss,and drainage tube indwelling time were not statistically significant(P>0.05),meanwhile BMI,combined diabetes,operation time,incision length,and postoperative drainage volume were statistically different(P<0.05)between the two groups.Statistically different factors were included in the multivariate Logistic regression analysis,the results showing that BMI and combined diabetes were independent risk factors for SSI after posterior cervical surgery(P=0.032,P=0.035).Conclusion: Body mass index(BMI)and diabetes are independent risk factors for SSI after posterior cervical surgery,and relevant precautions should be taken for high-risk patients.Once found after the surgery,complete relevant examination and take positive treatment early will improve the prognosis.