Extended Postoperative Antibiotics Do Not Reduce Infection After Posterior Cervical Fusion
Nicholas C. Bank, Andrew Larcher, Bradley Lauck, William Dyke, Charles A. Baumann, Douglas S. WeinbergStudy design:
Retrospective cohort study.
Objective:
To evaluate the efficacy of extended postoperative antibiotics (EPA) on postoperative infection rates in posterior cervical fusion (PCF).
Summary of background data:
Surgical site infection (SSI) following PCF continues to be a significant complication in spine surgery. While antibiotic prophylaxis is well established, the use of EPA remains controversial and less understood. Existing studies often include heterogeneous spinal procedures, and PCF-specific data is limited.
Methods:
Adult patients undergoing primary PCF between 2014 and 2024 were identified using the TriNetX database. Patients were stratified into those who received EPA and those who did not. Propensity score matching was performed to control for demographic, clinical, and surgical variables. Primary outcomes included 30-day and 90-day SSI development and wound complications. Secondary outcomes included pneumonia, urinary tract infection (UTI), and acute renal failure.
Results:
After matching, 942 patients were included in each cohort. There were no significant differences in infection rates between 30-day and 90-day groups. However, patients receiving EPA demonstrated higher rates of wound complications at both 30 days (3.6%
Conclusion:
EPA in PCF was not associated with reduced rates of SSI. Future prospective studies are warranted to further elucidate the effects of extended postoperative antibiotics on infections rates, wound healing, and medical complications following PCF.