ABSTRACT
STUDY DESIGN: Prospective study. PURPOSE: To compare the efficacy of 24-hour and 72-hour antibiotic prophylaxis in preventing surgical site infections (SSIs). OVERVIEW OF LITERATURE: Antimicrobial prophylaxis in surgical practice has become a universally accepted protocol for minimizing postoperative complications related to infections. Although prophylaxis is an accepted practice, a debate exists with regard to the antibiotic type and its administration duration for various surgical procedures. METHODS: Our institute is a tertiary care hospital with more than 100 spinal surgeries per year for various spine disorders in the department of orthopedics. We conducted this prospective study in our department from June 2012 to January 2015. A total of 326 patients were enrolled in this study, with 156 patients in the 72-hour antibiotic prophylaxis group (group A) and 170 patients in the 24-hour group (group B). Cefazolin was the antibiotic used in both groups. Two surgeons were involved in conducting all the spinal procedures. Our study compared SSIs among patients undergoing instrumented spinal fusion. RESULTS: The overall rate of SSIs was 1.8% with no statistical difference between the two groups. CONCLUSIONS: The 24-hour antimicrobial prophylaxis is as effective as the 72-hour dosage in instrumented spinal fusion surgery.
ABSTRACT
STUDY DESIGN: Prospective, nonrandomised, single center. OBJECTIVE: To study the clinico-radiologic and functional outcome after transfacetal screw fixation and fusion for low-grade degenerative spondylolisthesis of the lumbar spine. SUMMARY OF BACKGROUND DATA: Surgery for degenerative spondylolisthesis conventionally involves instrumented fusion using 3 column pedicle screw fixation systems. Recently transfacetal fusion techniques have been reported to produce good results without the surgical morbidity associated with posterolateral fusion and the neurologic complications associated with pedicle screw fixation. METHODS: 30 patients with low-grade degenerative spondylolisthesis of the lumbar and lumbosacral spine underwent transfacetal fusion using 2 cortical screws and local cancellous bone grafts. RESULTS: Clinical and radiologic evidence of fusion was obtained in 29 patients. One patient developed pseudoarthrosis with progression of slip and was reoperated. Quadruple visual analog scores and Oswestry disability assessment showed a significant improvement at 1-year follow-up. CONCLUSIONS: Degenerative spondylolisthesis with lower grade slips and normal anterior structures represent an ideal indication for transfacetal fusion. This is a simple and useful technique for short segment fusions of the lumbar spine.
