Effect Of Local Application By Vancomycin Powder On Spinal Fusion And The Prevention Of Incision Infection In Rabbits

Objective: This study aims to investigate the effect of vancomycin powder local application on postoperative wound infection and spinal fusion rates in a rabbit posteolateral lumbar spinal fusion model.Method : Forty-eight mature male rabbits were selected and divide into three groups randomly: no vancomycin(positive control),standard-dose vancomycin,and high-dose vancomycin,based on what was applied to the fusion bed and infection incision(no vancomycin powder was applied to the surgical site in the control group(n=18);the “standard-dose”group(14.3mg/kg;n=18)was treated with a dose of vacomycin based on this usage;the “high-dose”group(71.5mg/kg;n=18)was treated.).All rabbits underwent a posteolateral lumbar spinal fusion at the L-4 and L-5vertebrae.After the operation,the rabbits incision were closely observed,if there was infectious,we would take some tissue around the operation area to make sure if there was a infection under a histological analysis.Fusion was evaluated using plain anterposterior radiographs(X-ray and 3D CT image reconstruction)at 12 weeks after surgery.Then,the animals were humanely killed,and their lumbar spine were harvested for further evaluation: manual palpation and pathologic examination.We analyzed the difference of X-ray score between the three groups by Kruskal-Wallis test.And we analyzed the situation of incision's infection and the evaluation of CT image and palpation by using Fisher exact test.Results:(1)The rate of infection of “no vancomycin powder” was 37.5%,and in “standard-dose group”and “high-dose group”were zero.no matter the standard-dose or the high-dose vancomycin powder can effectively inhibit incision's infection(P=0.043?0.043).And there was no difference between “standard-dose group”and “high-dose group”(P=1).(2)The rate of lumbar spine fusion by using CT image did not differ significantly different between standard-dose group and control animals(P=0.704).And the high-dose vancomycinpowder can make less fusion rates than control group and standard-dose group.(P=0.029,0.004).No vancomycin powder was 62.5%,standard-dose was 75%,high-dose was 18.8%.(3)The rate of lumbar spine fusion by using palpation in all groups were different at 12 weeks after surgery(P=0.685?0.003?0).No vancomycin powder was68.8%,standard-dose was 81.3%,high-dose was 12.5%.(4)The rate of lumbar spine fusion by X-ray score did differ between high-dose group and control animals(P<0.05).And there was no difference between standard-dose group and control group.(P>0.05).Conclusion:(1)Local application of vancomycin powder can reduce the incidence of postoperative incision infection,and the postoperative incision infection decreases by the increase of vancomycin powder used in operative incision;(2)High-dose vancomycin powder can inhibits spinal fusion...