Short-Term Safety and Feasibility of Antibiotic-Impregnated Calcium Sulfate Beads in Cervicothoracic Spinal Deformity Surgery: A Retrospective Comparative Study
Sudhir Suggala, Charles A. Ogles, Adnan H. Shahid, Olivier Darbin, Mehdi Khaleghi, Richard P. MengerStudy Design:
Retrospective historical-control comparative cohort study.
Objective:
To evaluate the short-term safety and feasibility of vancomycin- and gentamicin-loaded calcium sulfate beads in cervicothoracic deformity surgery.
Summary of Background Data:
Antibiotic-impregnated calcium sulfate beads provide sustained local antibiotic delivery, but their safety and clinical value at the cervicothoracic junction (CTJ) remain poorly defined.
Materials and Methods:
A retrospective review included 67 adults undergoing cervicothoracic fusion by a single surgeon: 35 treated with antibiotic beads and 32 historical controls. Patients were chronologically assigned based on the implementation of the bead protocol. Outcomes included surgical site infection, wound complications, acute kidney injury, serum calcium and creatinine levels, drain removal timing, and hospital length of stay. Demographic, operative, and postoperative variables were obtained by chart review. Preoperative and 48-hour postoperative calcium and creatinine were assessed. Groups were compared using the prespecified univariate methods.
Results:
The beads group was older (63.9±1.7
Conclusion:
In this single-surgeon retrospective cohort, vancomycin- and gentamicin-loaded calcium sulfate beads were used in a more complex cervicothoracic deformity population without an observed increase in infection, renal injury, or clinically significant calcium-related complications. These findings support the short-term safety and feasibility of absorbable antibiotic beads in high-risk cervicothoracic deformity surgery. However, the low number of infection events limits conclusions regarding efficacy, and the historical-control design may confound interpretation of differences in perioperative outcomes. Larger prospective studies are needed to determine whether local antibiotic delivery reduces infection risk or improves recovery.
Level of Evidence:
Level III.