{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T18:15:15Z","timestamp":1777659315836,"version":"3.51.4"},"reference-count":24,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2022,6,17]],"date-time":"2022-06-17T00:00:00Z","timestamp":1655424000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III, Spanish Ministry of Science and Innovation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Although surgical risk factors for developing spine surgical site infections (S-SSI) have been identified, the impact of such knowledge in its prevention has not been demonstrated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We evaluated in 500 patients undergoing spine surgery between 2011 and 2019 at Hospital 12 de Octubre the changes in S-SSI rates over time. Surgical variables independently related to S-SSI were analyzed by univariate and multivariate analysis using binary logistic regression models. A case-control sub-analysis (1:4), matched by the surgical variables identified in the overall cohort was also performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty cases of S-SSI were identified (4%), with a significant decrease in the incidence rate across consecutive time periods (6.6% [2011-2014] vs .86% [2015-2019]; P-value &lt;.0001)). Multivariate analysis identified arthrodesis involving sacral levels (odds ratio [OR]: 2.57; 95% confidence interval [95%CI]: 1.02-6.47; P-value = .044) and instrumentation over 4-8 vertebrae (OR: 2.82; 95%CI: 1.1-7.1; P-value = .027) as independent risk factors for S-SSI. The reduction in the incidence of S-SSI concurred temporally with a reduction in instrumentations involving 4-8 vertebrae (55% vs 21.8%; P-value &lt;.0001) and sacral vertebrae (46.9% vs 24.6%; P-value &lt;.0001) across both periods. The case-control analysis matched by these surgical variables failed to identify other factors independently related to the occurrence of S-SSI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Spinal fusion of more than 4 levels and the inclusion of sacral levels were independently related to the risk of S-SSI. Optimization of surgical techniques by reducing these two types of instrumentation could significantly reduce S-SSI rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682221109557","type":"journal-article","created":{"date-parts":[[2022,6,17]],"date-time":"2022-06-17T03:43:50Z","timestamp":1655437430000},"page":"438-446","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Reduction of Instrumentation-Related Spine Surgical Site Infections After Optimization of Surgical Techniques. A Single Center Retrospective Analysis"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3446-1991","authenticated-orcid":false,"given":"Rafael","family":"San-Juan","sequence":"first","affiliation":[{"name":"Unit of Infectious Diseases, Hospital Universitario \u201c12 de Octubre\u201d, Instituto de Investigaci\u00f3n Sanitaria Hospital \u201c12 de Octubre\u201d (imas12), Complutense University of Madrid, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Igor","family":"Paredes","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Universitario \u201c12 de Octubre\u201d, Instituto de Investigaci\u00f3n Sanitaria Hospital \u201c12 de Octubre\u201d (imas12), Complutense University of Madrid, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther","family":"Ram\u00edrez-Nava","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Hospital Universitario \u201c12 de Octubre\u201d, Instituto de Investigaci\u00f3n Sanitaria Hospital \u201c12 de Octubre\u201d (imas12), Complutense University of Madrid, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4251-8356","authenticated-orcid":false,"given":"Juan","family":"Delgado-Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Universitario \u201c12 de Octubre\u201d, Instituto de Investigaci\u00f3n Sanitaria Hospital \u201c12 de Octubre\u201d (imas12), Complutense University of Madrid, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5742-1891","authenticated-orcid":false,"given":"Irene","family":"Panero","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Universitario \u201c12 de Octubre\u201d, Instituto de Investigaci\u00f3n Sanitaria Hospital \u201c12 de Octubre\u201d (imas12), Complutense University of Madrid, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula","family":"Hern\u00e1ndez-Ortiz","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Hospital Universitario \u201c12 de Octubre\u201d, Instituto de Investigaci\u00f3n Sanitaria Hospital \u201c12 de Octubre\u201d (imas12), Complutense University of Madrid, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elia","family":"Ram\u00edrez-Vicente","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Hospital Universitario \u201c12 de Octubre\u201d, Instituto de Investigaci\u00f3n Sanitaria Hospital \u201c12 de Octubre\u201d (imas12), Complutense University of Madrid, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Fern\u00e1ndez-Ruiz","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Hospital Universitario \u201c12 de Octubre\u201d, Instituto de Investigaci\u00f3n Sanitaria Hospital \u201c12 de Octubre\u201d (imas12), Complutense University of Madrid, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco","family":"L\u00f3pez-Medrano","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Hospital Universitario \u201c12 de Octubre\u201d, Instituto de Investigaci\u00f3n Sanitaria Hospital \u201c12 de Octubre\u201d (imas12), Complutense University of Madrid, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Corbella","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Hospital Universitario \u201c12 de Octubre\u201d, Instituto de Investigaci\u00f3n Sanitaria Hospital \u201c12 de Octubre\u201d (imas12), Complutense University of Madrid, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel","family":"Rodr\u00edguez-Goncer","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Hospital Universitario \u201c12 de Octubre\u201d, Instituto de Investigaci\u00f3n Sanitaria Hospital \u201c12 de Octubre\u201d (imas12), Complutense University of Madrid, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia","family":"Bra\u00f1as","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Instituto de Investigaci\u00f3n Sanitaria Hospital \u201c12 de Octubre\u201d (imas12), Hospital Universitario \u201c12 de Octubre\u201d, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfonso","family":"Lagares","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Universitario \u201c12 de Octubre\u201d, Instituto de Investigaci\u00f3n Sanitaria Hospital \u201c12 de Octubre\u201d (imas12), Complutense University of Madrid, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Mar\u00eda","family":"Aguado","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Hospital Universitario \u201c12 de Octubre\u201d, Instituto de Investigaci\u00f3n Sanitaria Hospital \u201c12 de Octubre\u201d (imas12), Complutense University of Madrid, Madrid, 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