Local Prophylactic Teicoplanin Effect on Spinal Fusion Surgery: A Comparative Retrospective Study

Nuh Mehmet Elmadağ; Deniz Kara; Anil Pulatkan; Vahdet Uçan; Dilek Hacer Cesme; Orkhan Aliyev; Hüseyin Doğu; Nail Demirel; Anas Abdallah

doi:10.1055/a-2103-7519

Journal of Neurological Surgery Part A: Central European Neurosurgery, Table of Contents

J Neurol Surg A Cent Eur Neurosurg 2024; 85(06): 539-548
DOI: 10.1055/a-2103-7519

Original Article

Local Prophylactic Teicoplanin Effect on Spinal Fusion Surgery: A Comparative Retrospective Study

Authors

Nuh Mehmet Elmadağ ^**

¹Department of Orthopedics and Traumatology, Bezmialem Vakif University, Istanbul, Turkey
Deniz Kara

¹Department of Orthopedics and Traumatology, Bezmialem Vakif University, Istanbul, Turkey
Anil Pulatkan

¹Department of Orthopedics and Traumatology, Bezmialem Vakif University, Istanbul, Turkey
Vahdet Uçan

¹Department of Orthopedics and Traumatology, Bezmialem Vakif University, Istanbul, Turkey
Dilek Hacer Cesme

²Department of Radiology, Acıbadem Taksim Hastanesi, Istanbul, Turkey
Orkhan Aliyev

¹Department of Orthopedics and Traumatology, Bezmialem Vakif University, Istanbul, Turkey
Hüseyin Doğu

³Department of Neurosurgery, Atlas University–Medicine Hospital, Bağcılar–Istanbul, Turkey
Nail Demirel

⁴Department of Neurosurgery, University of Health Sciences–Istanbul Training and Research Hospital, Samatya–Istanbul, Turkey
Anas Abdallah ^**^§

⁴Department of Neurosurgery, University of Health Sciences–Istanbul Training and Research Hospital, Samatya–Istanbul, Turkey

Abstract

Background Surgical site infection (SSI) is one of the most severe complications of spinal fusion surgery that lead to increased morbidity and mortality rates. Prophylactic antibiotic usage is one of the methods that reduce the possibility of SSI in this procedure. The aim of this study was to determine the effect of local subfascial teicoplanin usage on radiologic and functional outcomes and compare it to the effect of vancomycin on surgical outcomes in patients who underwent decompression with posterior instrumentation (DPI) for lumbar spinal stenosis (LSS).

Methods Medical charts of patients with LSS who received DPI and met the study criteria were divided into three groups: the teicoplanin group included patients who underwent DPI with local teicoplanin before closure, the vancomycin group included patients who underwent DPI with local vancomycin, and the control group included patients who underwent DPI without any local prophylactic antibiotics.

Results A total of 101 patients were included in the study. No significant differences were found among groups regarding demographics, follow-up, and clinical and functional outcomes. No significant differences were observed among groups regarding postoperative improvements in SF-36-MCS, SF-36-PCS, Oswestry Disability Index, and Visual Analog Scale (VAS; p > 0.05). In the teicoplanin and vancomycin groups, the SSI rate was lower than that in the control group (2/35, 1/34, and 5/32, respectively, p = 0.136) without statistical significance; however, the postoperative fusion volume was significantly higher in the teicoplanin group when compared to the other groups (3.35 ± 1.08, 2.68 ± 1.17, and 2.65 ± 1.28 cm³, respectively, p = 0.007).

Conclusions Although its cost is relatively higher, teicoplanin was a good alternative to vancomycin in preventing SSIs with a higher fusion rate, but no superiority was observed regarding other outcomes.

Keywords

surgical site infections - spinal fusion surgery - prophylactic antibiotics - teicoplanin - vancomycin - fusion mass

Full Text

References

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