University of Utah
The research team hypothesizes that ceftazidime, in conjunction with vancomycin, is a safe and effective way to prevent surgical site infections in lumbar spinal surgery. Objective 1: Evaluate the drain and serum concentrations of ceftazidime + vancomycin from 0-3 days postoperative. Hypothesis: The investigators hypothesize that intrawound ceftazidime will remain concentrated at the wound site, and there will be minimal absorption of ceftazidime into the circulatory system. Objective 2: Evaluate incidence of surgical site infections (within 90 days postoperative) and pseudoarthrosis (within 2 years postoperative) after the use of ceftazidime in addition to vancomycin. Hypothesis: The investigators hypothesize that intrawound ceftazidime, in conjunction with intrawound vancomycin, is a safe and effective way to reduce surgical site infections following lumbar spine surgery, while having little effect on construct fusion (e.g., pseudoarthrosis). Objective 3: Evaluate ceftazidime concentration effects on osteoblasts, specifically metabolic activity and osteogenic protein expression profiles. Hypothesis: The investigators hypothesize that ceftazidime concentrations measured from drain samples will not have an effect on metabolic activity and osteogenic protein expression of osteoblasts.
Surgical site infections (SSI) present a challenge in orthopedic spine surgery and can cause significant morbidity and mortality, as well as increased healthcare costs. Reported incidence of spine SSI varies from 1-14%, with primary lumbar fusions at 8.8% and revision lumbar fusions at 12.2%. Current practices to prevent SSIs include the use of topical antibiotics, particularly vancomycin, in addition to standard intra-operational IV antibiotics. However, previous studies show conflicting evidence regarding the efficacy of topical vancomycin in the prevention of SSIs. As such, there is no cle…
Inclusion Criteria: * Patient age greater than or equal to 18 at time of surgery . * Patient undergoing thoracolumbar spinal fusion of less than or equal to 10 surgical levels by orthopedic spine faculty at the University of Utah. Exclusion Criteria: * Patient age less than 18 at time of surgery. * Patient not operated on at the University of Utah by orthopedic spine faculty . * Patient treated nonoperatively only . * Patient treated operatively, but with over 10 spinal levels fused. * Patient treated by the University of Utah orthopedic spine faculty, but not undergoing thoracolumbar fusio…
1g:1g ratio of topical ceftazidime and vancomycin after lumbar spinal fusion surgery.