LAUSR

STUDY DESIGN Case control series. OBJECTIVE To evaluate and compare the effectiveness of methods to decrease Surgical site infections (SSI) following spine tumor surgery. SUMMARY OF BACKGROUND DATA With the aging population of the United States, the prevalence of cancer and associated metastatic spine disease is increasing. The most common complication of spine tumor surgery is SSI. METHODS This a single institution case control series of patients undergoing spine tumor surgery from 6/2003 to 10/2018. Patients were grouped in the following groups: Betadine irrigation and intrawound vancomycin powder (BIVP), intrawound vancomycin powder only (IVP) and patients receiving neither (NONE). The primary outcome was surgical site infections/wound complications. RESULTS 151 spine tumor patients undergoing 174 procedures meeting our inclusion criteria were identified. The BIVP group had 60 patients (73 procedures); the IVP group had 46 patients (47 procedures) and the NONE group had 45 patients (54 procedures). The overall infection rate was 8.6% of all procedures (15/174) and 9.9% (15/151) of all patients. Bivariate analysis comparing patients with and without infections noted the patients with surgical site infections had significantly higher rates of pre-operative radiation treatment (53.3% in infection group versus 25.5% in non-infection group), p = 0.02. Patients undergoing procedures in the BIVP group had a significantly lower rate of infections (2.7%) as compared to the patients in the IVP (12.8%) and NONE (13%) groups, p = 0.04. Stepwise regression analysis was used to evaluate further factors associated with surgical site infections. Elevated BMI was significantly associated with surgical site infections in the model p = 0.02, OR 1.14. BIVP was also protective against infections as compared to the IVP and NONE groups, p = 0.02, OR 0.02. CONCLUSIONS BIVP led to a significant decrease in SSI rates following spine tumor surgery. Administration of BIVP is not time consuming and decreased SSI rates. LEVEL OF EVIDENCE 3.