Association between intraoperative computed tomography navigation system and incidence of surgical site infection in patients with spinal surgeries: a retrospective analysis

• Published in: Journal of orthopaedic surgery and research 2022-01, Vol.17 (1), p.52-52, Article 52
• Main Authors: Kumagai, Gentaro, Wada, Kanichiro, Tanaka, Sunao, Asari, Toru, Nitobe, Yohshiro, Ishibashi, Yasuyuki
• Format: Article
• Language: English
• Subjects: Age; Aged; Antibiotics; Back surgery; Body mass index; Care and treatment; Computed tomography; Contamination; CT imaging; Diabetes; Electronics in navigation; Female; Fluoroscopy; Health aspects; Humans; Hypertension; Imaging, Three-Dimensional; Incidence; Infection; Infections; Intraoperative CT; Intraoperative fluoroscopy; Laboratories; Male; Medical imaging; Medical research; Medicine, Experimental; Middle Aged; Navigation systems; Orthopedics; Patients; Retrospective Studies; Risk factors; Skin; Spinal surgery; Spine - surgery; Steroids; Surgery; Surgery, Computer-Assisted; Surgical site infection; Surgical site infections; Surgical Wound Infection - diagnostic imaging; Surgical Wound Infection - epidemiology; Surgical Wound Infection - etiology; Tomography; Tomography, X-Ray Computed - methods; Variables
• ISSN: 1749-799X; 1749-799X
• DOI: 10.1186/s13018-022-02936-6

Although the use of intraoperative computed tomography (CT)-based navigation systems is unlikely to cause intraoperative contamination more than the use of intraoperative fluoroscopy, the association between intraoperative CT/navigation and surgical site infections (SSIs) remains unclear. We investigated the incidence of SSIs and the association between intraoperative CT/navigation and SSIs for spinal surgeries. Of the 512 patients who underwent spinal surgery between April 2016 and December 2020, 304 underwent C-arm intraoperative fluoroscopy and/or Medtronic O-arm intraoperative CT/navigation system. We investigated the incidence of SSIs in patients with four techniques; no intraoperative imaging C-arm only, O-arm only, and both O- and C-arm used. Multivariate logistic analyses were conducted using the prevalence of SSIs as the dependent variable. The independent variables were age, sex, and potential confounders including preoperative Japanese Orthopaedic Association (JOA) score, use of instrumentation, C-arm, and/or O-arm. The incidence of the SSIs in patients with no imaging, C-arm only, O-arm only, and both modalities used was 1.9%, 7.3%, 4.7%, and 8.3%, respectively. There was no significant difference in the incidence of SSIs between the four techniques. Multivariate logistic analyses showed a significant correlation between the prevalence of SSI and JOA scores (odds ratio, 0.878; 95% CI 0.759-0.990) and use of instrumentation (odds ratio, 6.241; 95% CI 1.113-34.985), but not use of O-arm. The incidence of the SSIs in patients with only O-arm used was 4.7%. Preoperative clinical status and use of instrumentation, but not use of the O-arm, were associated with SSIs after spinal surgeries.