Decreasing the Risk of Infection After Cervical Spinal Surgery

vancomycin powder cuts rate of infection after cervical spinal surgeryInfection after cervical spinal surgery is just one possible complication of surgery to treat neck pain. Finding ways to reduce the risk of infection is important, especially as this complication can lead to failed back surgery syndrome, serious scarring, ongoing and worsening neck pain, and even paralysis or death, depending on how serious the infection becomes and how responsive it is to treatment.

One way in which surgeons are trying to reduce the rate of infection after cervical spinal surgery is to use alcohol foam and vancomycin powder (antibiotic powder), along with a second drain to help prevent fluid build-up after surgery and thereby reduce the likelihood of bacteria and other microorganisms getting a foothold.

Presenting research at the American Academy of Orthopaedic Surgeons 2011 Annual Meeting, scientists from Albert Einstein Medical Center and Shriners Hospital for Children in Philadelphia, Pennsylvania, noted that this strategy could significantly reduce the rate of infection in obese patients undergoing neck surgery on the spine.

No Infection After Cervical Spinal Surgery

Not one of the 195 patients in their study who underwent their operation using the new protocol had a post-surgical infection, whereas typical infection rates are between 1% and 5%. A follow-up study found no cases of infection in an additional 50 patients undergoing their cervical spinal surgery using the vancomycin powder, alcohol, and two-drain protocol.

Normal practice is to use intravenous cephalosporin to decrease the likelihood of post-surgical infection, but the researchers in this study noted that this drug fails to kill more than half of the staphylococcus organisms present in the hospital environment, which could increase antibiotic resistance in general and lead to persistent infections in patients. The use of vancomycin powder in the wound itself, along with alcohol, appears to reduce infection rates significantly, and would not contribute as substantially to MRSA and other resistant bacterial strains.

Using vancomycin at the incision site itself appears to carry very little risk, with no complications or resistant bacterial development in any of the 1150 or so patients undergoing this type of treatment. By reducing the risk of infection after cervical spinal surgery, this also reduces the likelihood that a patient will have to undergo a second neck surgery and can usually leave hospital much faster.


American Academy of Orthopaedic Surgeons 2011 Annual Meeting: Abstract 30. Presented February 15, 2011.

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