{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T15:06:56Z","timestamp":1788534416418,"version":"build-2803163510"},"reference-count":46,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>Wound infections following spinal surgery for deformity place a high toll on patients, providers, and the health care system. The prophylactic application of intraoperative vancomycin powder has been shown to lower the infection risk after thoracolumbar decompression and fusion for deformity correction. The purpose of this study was to assess the microbiological patterns of postoperative surgical site infections (SSIs) after prophylactic use of vancomycin powder in adult patients undergoing spinal deformity surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>All cases involving adult patients who underwent spinal deformity reconstruction at Duke University Medical Center between 2011 and 2013 with a minimum of 3 months of clinical follow-up were retrospectively reviewed. In all cases included in the study, crystalline vancomycin powder was applied to the surgical bed for infection prophylaxis. Baseline characteristics, operative details, rates of wound infection, and microbiological data for each case were gathered by direct medical record review.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>A total of 1200 consecutive spine operations were performed for deformity between 2011 and 2013. Review of the associated records demonstrated 34 cases of SSI, yielding an SSI rate of 2.83%. The patients\u2019 mean age (\u00b1 SD) was 62.08 \u00b1 14.76 years. The patients\u2019 mean body mass index was 30.86 \u00b1 7.15 kg\/m<jats:sup>2<\/jats:sup>, and 29.41% had a history of diabetes. The average dose of vancomycin powder was 1.41 \u00b1 2.77 g (range 1\u20137 g). Subfascial drains were placed in 88% of patients. All SSIs occurred within 30 days of surgery, with deep wound infections accounting for 50%. In 74% of the SSIs cultures were positive, with about half the organisms being gram negative, such as <jats:italic>Citrobacter freundii<\/jats:italic>, <jats:italic>Proteus mirabilis<\/jats:italic>, <jats:italic>Morganella morgani<\/jats:italic>, and <jats:italic>Pseudomonas aeruginosa<\/jats:italic>. There were no adverse clinical outcomes related to the local application of vancomycin.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Our study suggests that in the setting of prophylactic vancomycin powder use, the preponderance of SSIs are caused by gram-negative organisms or are polymicrobial. Further randomized control trials of prophylactic adjunctive measures are warranted to help guide the choice of empirical antibiotic therapy while awaiting culture data.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2017.2.spine161310","type":"journal-article","created":{"date-parts":[[2017,6,30]],"date-time":"2017-06-30T14:02:27Z","timestamp":1498831347000},"page":"328-334","source":"Crossref","is-referenced-by-count":55,"title":["Prophylactic use of intraoperative vancomycin powder and postoperative infection: an analysis of microbiological patterns in 1200 consecutive surgical cases"],"prefix":"10.3171","volume":"27","author":[{"given":"Owoicho","family":"Adogwa","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Rush University Medical Center;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aladine A.","family":"Elsamadicy","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Sergesketter","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria D.","family":"Vuong","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Rush University Medical Center;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankit I.","family":"Mehta","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The University of Illinois at Chicago, Illinois;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raul A.","family":"Vasquez","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Kentucky, Lexington, Kentucky;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yale University, New Haven, Connecticut; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos A.","family":"Bagley","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Texas Southwestern, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac O.","family":"Karikari","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"E1425","DOI":"10.1097\/BRS.0b013e3182a42a68","article-title":"Surgical site infections in spine surgery: identification of microbiologic and surgical characteristics in 239 cases","volume":"38","author":"Abdul-Jabbar A","year":"2013","unstructured":"Abdul-Jabbar A, Berven SH, Hu SS, Chou D, Mummaneni PV, Takemoto S, : Surgical site infections in spine surgery: identification of microbiologic and surgical characteristics in 239 cases. Spine (Phila Pa 1976) 38:E1425\u2013E1431, 201310.1097\/BRS.0b013e3182a42a68"},{"key":"b2","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1097\/BRS.0000000000000276","article-title":"Patient characteristics associated with increased postoperative length of stay and readmission after elective laminectomy for lumbar spinal stenosis","volume":"39","author":"Basques BA","year":"2014","unstructured":"Basques BA, Varthi AG, Golinvaux NS, Bohl DD, Grauer JN: Patient characteristics associated with increased postoperative length of stay and readmission after elective laminectomy for lumbar spinal stenosis. Spine (Phila Pa 1976) 39:833\u2013840, 20142452599610.1097\/BRS.0000000000000276"},{"key":"b3","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"1693","DOI":"10.1097\/BRS.0000000000001591","article-title":"Malnutrition predicts infectious and wound complications following posterior lumbar spinal fusion","volume":"41","author":"Bohl DD","year":"2016","unstructured":"Bohl DD, Shen MR, Mayo BC, Massel DH, Long WW, Modi KD, : Malnutrition predicts infectious and wound complications following posterior lumbar spinal fusion. Spine (Phila Pa 1976) 41:1693\u20131699, 20162703558410.1097\/BRS.0000000000001591"},{"key":"b4","series-title":"J Arthroplasty","doi-asserted-by":"publisher","first-page":"616","DOI":"10.1016\/j.arth.2015.09.051","article-title":"Expanded gram-negative antimicrobial prophylaxis reduces surgical site infections in hip arthroplasty","volume":"31","author":"Bosco JA","year":"2016","unstructured":"Bosco JA, Catanzano AJ, Stachel AG, Phillips MS: Expanded gram-negative antimicrobial prophylaxis reduces surgical site infections in hip arthroplasty. J Arthroplasty 31:616\u2013621, 201610.1016\/j.arth.2015.09.05126521131"},{"key":"b5","series-title":"Surg Infect (Larchmt)","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1089\/sur.2013.250","article-title":"Adverse clinical outcomes and resource utilization associated with methicillin-resistant and methicillin-sensitive Staphylococcus aureus infections after elective surgery","volume":"16","author":"Campbell RS","year":"2015","unstructured":"Campbell RS, Emons MF, Mardekian J, Girgenti D, Gaffney M, Yu H: Adverse clinical outcomes and resource utilization associated with methicillin-resistant and methicillin-sensitive Staphylococcus aureus infections after elective surgery. Surg Infect (Larchmt) 16:543\u2013552, 201510.1089\/sur.2013.25026125541"},{"key":"b6","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1016\/j.spinee.2013.10.012","article-title":"Effectiveness of local vancomycin powder to decrease surgical site infections: a meta-analysis","volume":"14","author":"Chiang HY","year":"2014","unstructured":"Chiang HY, Herwaldt LA, Blevins AE, Cho E, Schweizer ML: Effectiveness of local vancomycin powder to decrease surgical site infections: a meta-analysis. Spine J 14:397\u2013407, 20142437368210.1016\/j.spinee.2013.10.012"},{"key":"b7","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1097\/BRS.0000000000000655","article-title":"The impact of obesity on short- and long-term outcomes after lumbar fusion","volume":"40","author":"De la Garza-Ramos R","year":"2015","unstructured":"De la Garza-Ramos R, Bydon M, Abt NB, Sciubba DM, Wolinsky JP, Bydon A, : The impact of obesity on short- and long-term outcomes after lumbar fusion. Spine (Phila Pa 1976) 40:56\u201361, 201510.1097\/BRS.0000000000000655"},{"key":"b8","series-title":"Am J Infect Control","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1016\/j.ajic.2008.12.010","article-title":"Surgical site infection: incidence and impact on hospital utilization and treatment costs","volume":"37","author":"de Lissovoy G","year":"2009","unstructured":"de Lissovoy G, Fraeman K, Hutchins V, Murphy D, Song D, Vaughn BB: Surgical site infection: incidence and impact on hospital utilization and treatment costs. Am J Infect Control 37:387\u2013397, 200910.1016\/j.ajic.2008.12.010"},{"key":"b9","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","DOI":"10.1097\/BSD.0000000000000045","article-title":"Is intraoperative local vancomycin powder the answer to surgical site infections in spine surgery?","author":"Dennis HH","unstructured":"Dennis HH, Wei DT, Darren KZ, Shantakumar JT, Kumar N, Lau LL, : Is intraoperative local vancomycin powder the answer to surgical site infections in spine surgery? Spine (Phila Pa 1976) [epub ahead of print], 201610.1097\/BSD.0000000000000045"},{"key":"b10","series-title":"J Thorac Cardiovasc Surg","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1067\/mtc.2002.119698","article-title":"Vancomycin versus cefazolin prophylaxis for cardiac surgery in the setting of a high prevalence of methicillin-resistant staphylococcal infections","volume":"123","author":"Finkelstein R","year":"2002","unstructured":"Finkelstein R, Rabino G, Mashiah T, Bar-El Y, Adler Z, Kertzman V, : Vancomycin versus cefazolin prophylaxis for cardiac surgery in the setting of a high prevalence of methicillin-resistant staphylococcal infections. J Thorac Cardiovasc Surg 123:326\u2013332, 20021182829310.1067\/mtc.2002.119698"},{"key":"b11","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1097\/BRS.0000000000000241","article-title":"Intraoperative vancomycin use in spinal surgery: single institution experience and microbial trends","volume":"39","author":"Ghobrial GM","year":"2014","unstructured":"Ghobrial GM, Thakkar V, Andrews E, Lang M, Chitale A, Oppenlander ME, : Intraoperative vancomycin use in spinal surgery: single institution experience and microbial trends. Spine (Phila Pa 1976) 39:550\u2013555, 20142448096610.1097\/BRS.0000000000000241"},{"key":"b12","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"331","DOI":"10.3171\/2013.6.SPINE121105","article-title":"Comparative effectiveness and cost-benefit analysis of local application of vancomycin powder in posterior spinal fusion for spine trauma: clinical article","volume":"19","author":"Godil SS","year":"2013","unstructured":"Godil SS, Parker SL, O\u2019Neill KR, Devin CJ, McGirt MJ: Comparative effectiveness and cost-benefit analysis of local application of vancomycin powder in posterior spinal fusion for spine trauma: clinical article. J Neurosurg Spine 19:331\u2013335, 20132384835010.3171\/2013.6.SPINE121105"},{"key":"b13","series-title":"Infect Control Hosp Epidemiol","doi-asserted-by":"publisher","first-page":"1458","DOI":"10.1017\/ice.2016.193","article-title":"Risk factors for surgical site infections following adult spine operations","volume":"37","author":"Haleem A","year":"2016","unstructured":"Haleem A, Chiang HY, Vodela R, Behan A, Pottinger JM, Smucker J, : Risk factors for surgical site infections following adult spine operations. Infect Control Hosp Epidemiol 37:1458\u20131467, 20162757306710.1017\/ice.2016.193"},{"key":"b14","series-title":"J Shoulder Elbow Surg","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1016\/j.jse.2016.07.071","article-title":"The cost effectiveness of vancomycin for preventing infections after shoulder arthroplasty: a break-even analysis","volume":"26","author":"Hatch MD","year":"2017","unstructured":"Hatch MD, Daniels SD, Glerum KM, Higgins LD: The cost effectiveness of vancomycin for preventing infections after shoulder arthroplasty: a break-even analysis. J Shoulder Elbow Surg 26:472\u2013477, 201710.1016\/j.jse.2016.07.07127727049"},{"key":"b15","series-title":"World J Orthop","doi-asserted-by":"publisher","first-page":"182","DOI":"10.5312\/wjo.v3.i11.182","article-title":"Management of postoperative spinal infections","volume":"3","author":"Hegde V","year":"2012","unstructured":"Hegde V, Meredith DS, Kepler CK, Huang RC: Management of postoperative spinal infections. World J Orthop 3:182\u2013189, 20122333007310.5312\/wjo.v3.i11.182"},{"key":"b16","series-title":"J Spinal Disord Tech","first-page":"E584","article-title":"Intrawound vancomycin powder decreases staphylococcal surgical site infections after posterior instrumented spinal arthrodesis","volume":"28","author":"Heller A","year":"2015","unstructured":"Heller A, McIff TE, Lai SM, Burton DC: Intrawound vancomycin powder decreases staphylococcal surgical site infections after posterior instrumented spinal arthrodesis. J Spinal Disord Tech 28:E584\u2013E589, 2015"},{"key":"b17","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1227\/NEU.0000000000001018","article-title":"Understanding the impact of obesity on short-term outcomes and in-hospital costs after instrumented spinal fusion","volume":"78","author":"Higgins DM","year":"2016","unstructured":"Higgins DM, Mallory GW, Planchard RF, Puffer RC, Ali M, Gates MJ, : Understanding the impact of obesity on short-term outcomes and in-hospital costs after instrumented spinal fusion. Neurosurgery 78:127\u2013132, 201610.1227\/NEU.000000000000101826352096"},{"key":"b18","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"727","DOI":"10.3171\/jns.1975.43.6.0727","article-title":"Prophylactic antibiotics and wound infections following laminectomy for lumber disc herniation","volume":"43","author":"Horwitz NH","year":"1975","unstructured":"Horwitz NH, Curtin JA: Prophylactic antibiotics and wound infections following laminectomy for lumber disc herniation. J Neurosurg 43:727\u2013731, 1975119493810.3171\/jns.1975.43.6.0727"},{"key":"b19","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"1891","DOI":"10.1007\/s00586-016-4501-9","article-title":"Surgical site infections following operative management of cervical spondylotic myelopathy: prevalence, predictors of occurence, and influence on peri-operative outcomes","volume":"25","author":"Jalai CM","year":"2016","unstructured":"Jalai CM, Worley N, Poorman GW, Cruz DL, Vira S, Passias PG: Surgical site infections following operative management of cervical spondylotic myelopathy: prevalence, predictors of occurence, and influence on peri-operative outcomes. Eur Spine J 25:1891\u20131896, 201610.1007\/s00586-016-4501-926988555"},{"key":"b20","series-title":"Clin Orthop Relat Res","doi-asserted-by":"publisher","first-page":"968","DOI":"10.1007\/s11999-013-3346-3","article-title":"Does obesity affect the surgical outcome and complication rates of spinal surgery? A meta-analysis","volume":"472","author":"Jiang J","year":"2014","unstructured":"Jiang J, Teng Y, Fan Z, Khan S, Xia Y: Does obesity affect the surgical outcome and complication rates of spinal surgery? A meta-analysis. Clin Orthop Relat Res 472:968\u2013975, 201410.1007\/s11999-013-3346-324146361"},{"key":"b21","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"974","DOI":"10.3171\/2014.8.SPINE1445","article-title":"A meta-analysis of spinal surgical site infection and vancomycin powder","volume":"21","author":"Khan NR","year":"2014","unstructured":"Khan NR, Thompson CJ, DeCuypere M, Angotti JM, Kalobwe E, Muhlbauer MS, : A meta-analysis of spinal surgical site infection and vancomycin powder. J Neurosurg Spine 21:974\u2013983, 201410.3171\/2014.8.SPINE144525259555"},{"key":"b22","series-title":"Infect Control Hosp Epidemiol","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1086\/501572","article-title":"The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs","volume":"20","author":"Kirkland KB","year":"1999","unstructured":"Kirkland KB, Briggs JP, Trivette SL, Wilkinson WE, Sexton DJ: The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol 20:725\u2013730, 199910.1086\/50157210580621"},{"key":"b23","series-title":"Public Health Rep","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1177\/003335490712200205","article-title":"Estimating health care\u2013associated infections and deaths in U.S. hospitals, 2002","volume":"122","author":"Klevens RM","year":"2007","unstructured":"Klevens RM, Edwards JR, Richards CL Jr, Horan TC, Gaynes RP, Pollock DA, : Estimating health care\u2013associated infections and deaths in U.S. hospitals, 2002. Public Health Rep 122:160\u2013166, 200710.1177\/00333549071220020517357358"},{"key":"b24","series-title":"JAMA","doi-asserted-by":"publisher","first-page":"1763","DOI":"10.1001\/jama.298.15.1763","article-title":"Invasive methicillin-resistant Staphylococcus aureus infections in the United States","volume":"298","author":"Klevens RM","year":"2007","unstructured":"Klevens RM, Morrison MA, Nadle J, Petit S, Gershman K, Ray S, : Invasive methicillin-resistant Staphylococcus aureus infections in the United States. JAMA 298:1763\u20131771, 20071794023110.1001\/jama.298.15.1763"},{"key":"b25","series-title":"J Bone Joint Surg Am","doi-asserted-by":"publisher","first-page":"1627","DOI":"10.2106\/JBJS.J.00039","article-title":"Risk factors for postoperative infection following posterior lumbar instrumented arthrodesis","volume":"93","author":"Koutsoumbelis S","year":"2011","unstructured":"Koutsoumbelis S, Hughes AP, Girardi FP, Cammisa FP Jr, Finerty EA, Nguyen JT, : Risk factors for postoperative infection following posterior lumbar instrumented arthrodesis. J Bone Joint Surg Am 93:1627\u20131633, 20112191557810.2106\/JBJS.J.00039"},{"key":"b26","series-title":"Epidemiol Infect","doi-asserted-by":"publisher","first-page":"2473","DOI":"10.1017\/S0950268813000253","article-title":"Evaluating the clinical and economic burden of healthcare-associated infections during hospitalization for surgery in France","volume":"141","author":"Lamarsalle L","year":"2013","unstructured":"Lamarsalle L, Hunt B, Schauf M, Szwarcensztein K, Valentine WJ: Evaluating the clinical and economic burden of healthcare-associated infections during hospitalization for surgery in France. Epidemiol Infect 141:2473\u20132482, 20132344566510.1017\/S0950268813000253"},{"key":"b27","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"517","DOI":"10.1016\/j.wneu.2015.12.085","article-title":"Preoperative predictors of spinal infection within the National Surgical Quality Inpatient Database","volume":"89","author":"Lieber B","year":"2016","unstructured":"Lieber B, Han B, Strom RG, Mullin J, Frempong-Boadu AK, Agarwal N, : Preoperative predictors of spinal infection within the National Surgical Quality Inpatient Database. World Neurosurg 89:517\u2013524, 201610.1016\/j.wneu.2015.12.08526748173"},{"key":"b28","series-title":"Spine (Phila Pa 1976)","article-title":"Risk factors for postoperative infections following single level lumbar fusion surgery","author":"Lim S","unstructured":"Lim S, Edelstein AI, Patel AA, Kim BD, Kim JY: Risk factors for postoperative infections following single level lumbar fusion surgery. Spine (Phila Pa 1976) [epub ahead of print], 2014"},{"key":"b29","series-title":"Infect Control Hosp Epidemiol","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1086\/501620","article-title":"Guideline for prevention of surgical site infection, 1999","volume":"20","author":"Mangram AJ","year":"1999","unstructured":"Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR: Guideline for prevention of surgical site infection, 1999. Infect Control Hosp Epidemiol 20:250\u2013280, 199910.1086\/50162010219875"},{"key":"b30","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1097\/BRS.0000000000000071","article-title":"Experience with intrawound vancomycin powder for spinal deformity surgery","volume":"39","author":"Martin JR","year":"2014","unstructured":"Martin JR, Adogwa O, Brown CR, Bagley CA, Richardson WJ, Lad SP, : Experience with intrawound vancomycin powder for spinal deformity surgery. Spine (Phila Pa 1976) 39:177\u2013184, 201410.1097\/BRS.000000000000007124158179"},{"key":"b31","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"1652","DOI":"10.1097\/BRS.0b013e318241b186","article-title":"2012 Young Investigator Award winner: The distribution of body mass as a significant risk factor for lumbar spinal fusion postoperative infections","volume":"37","author":"Mehta AI","year":"2012","unstructured":"Mehta AI, Babu R, Karikari IO, Grunch B, Agarwal VJ, Owens TR, : 2012 Young Investigator Award winner: The distribution of body mass as a significant risk factor for lumbar spinal fusion postoperative infections. Spine (Phila Pa 1976) 37:1652\u20131656, 20122214628510.1097\/BRS.0b013e318241b186"},{"key":"b32","series-title":"Pediatr Infect Dis J","doi-asserted-by":"publisher","first-page":"704","DOI":"10.1097\/INF.0b013e31816fca72","article-title":"Timing of preoperative antibiotic prophylaxis: a modifiable risk factor for deep surgical site infections after pediatric spinal fusion","volume":"27","author":"Milstone AM","year":"2008","unstructured":"Milstone AM, Maragakis LL, Townsend T, Speck K, Sponseller P, Song X, : Timing of preoperative antibiotic prophylaxis: a modifiable risk factor for deep surgical site infections after pediatric spinal fusion. Pediatr Infect Dis J 27:704\u2013708, 20081857443610.1097\/INF.0b013e31816fca72"},{"issue":"Suppl 4","key":"b33","series-title":"Eur Spine J","first-page":"S476","article-title":"Prophylactic intraoperative powdered vancomycin and postoperative deep spinal wound infection: 1,512 consecutive surgical cases over a 6-year period","volume":"21","author":"Molinari RW","year":"2012","unstructured":"Molinari RW, Khera OA, Molinari WJ III: Prophylactic intraoperative powdered vancomycin and postoperative deep spinal wound infection: 1,512 consecutive surgical cases over a 6-year period. Eur Spine J 21 (Suppl 4):S476\u2013S482, 2012"},{"key":"b34","series-title":"Clin Infect Dis","doi-asserted-by":"publisher","first-page":"1132","DOI":"10.1086\/522186","article-title":"National trends in Staphylococcus aureus infection rates: impact on economic burden and mortality over a 6-year period (1998\u20132003)","volume":"45","author":"Noskin GA","year":"2007","unstructured":"Noskin GA, Rubin RJ, Schentag JJ, Kluytmans J, Hedblom EC, Jacobson C, : National trends in Staphylococcus aureus infection rates: impact on economic burden and mortality over a 6-year period (1998\u20132003). Clin Infect Dis 45:1132\u20131140, 200710.1086\/522186"},{"key":"b35","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"641","DOI":"10.1016\/j.spinee.2011.04.025","article-title":"Reduced surgical site infections in patients undergoing posterior spinal stabilization of traumatic injuries using vancomycin powder","volume":"11","author":"O\u2019Neill KR","year":"2011","unstructured":"O\u2019Neill KR, Smith JG, Abtahi AM, Archer KR, Spengler DM, McGirt MJ, : Reduced surgical site infections in patients undergoing posterior spinal stabilization of traumatic injuries using vancomycin powder. Spine J 11:641\u2013646, 201110.1016\/j.spinee.2011.04.02521600853"},{"key":"b36","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"1422","DOI":"10.1097\/BRS.0b013e3181a03013","article-title":"Incidence, prevalence, and analysis of risk factors for surgical site infection following adult spinal surgery","volume":"34","author":"Pull ter Gunne AF","year":"2009","unstructured":"Pull ter Gunne AF, Cohen DB: Incidence, prevalence, and analysis of risk factors for surgical site infection following adult spinal surgery. Spine (Phila Pa 1976) 34:1422\u20131428, 200910.1097\/BRS.0b013e3181a03013"},{"key":"b37","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"418","DOI":"10.1227\/00006123-199509000-00008","article-title":"Antibiotic penetration into cervical discs","volume":"37","author":"Rhoten RL","year":"1995","unstructured":"Rhoten RL, Murphy MA, Kalfas IH, Hahn JF, Washington JA: Antibiotic penetration into cervical discs. Neurosurgery 37:418\u2013421, 199510.1227\/00006123-199509000-000087501105"},{"key":"b38","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1097\/BRS.0b013e318162016e","article-title":"Infection after the surgical treatment of adolescent idiopathic scoliosis: evaluation of the diagnosis, treatment, and impact on clinical outcomes","volume":"33","author":"Rihn JA","year":"2008","unstructured":"Rihn JA, Lee JY, Ward WT: Infection after the surgical treatment of adolescent idiopathic scoliosis: evaluation of the diagnosis, treatment, and impact on clinical outcomes. Spine (Phila Pa 1976) 33:289\u2013294, 200810.1097\/BRS.0b013e318162016e18303461"},{"key":"b39","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"1520","DOI":"10.1097\/BRS.0000000000000435","article-title":"Impact of increased body mass index on outcomes of elective spinal surgery","volume":"39","author":"Seicean A","year":"2014","unstructured":"Seicean A, Alan N, Seicean S, Worwag M, Neuhauser D, Benzel EC, : Impact of increased body mass index on outcomes of elective spinal surgery. Spine (Phila Pa 1976) 39:1520\u20131530, 20142485958410.1097\/BRS.0000000000000435"},{"key":"b40","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"556","DOI":"10.1097\/BRS.0b013e3181eadd41","article-title":"Rates of infection after spine surgery based on 108,419 procedures: a report from the Scoliosis Research Society Morbidity and Mortality Committee","volume":"36","author":"Smith JS","year":"2011","unstructured":"Smith JS, Shaffrey CI, Sansur CA, Berven SH, Fu KM, Broadstone PA, : Rates of infection after spine surgery based on 108,419 procedures: a report from the Scoliosis Research Society Morbidity and Mortality Committee. Spine (Phila Pa 1976) 36:556\u2013563, 201110.1097\/BRS.0b013e3181eadd4121192288"},{"key":"b41","series-title":"J Neurosurg Spine","article-title":"Impact of obesity on complications, infection, and patient-reported outcomes in adult spinal deformity surgery","author":"Soroceanu A","unstructured":"Soroceanu A, Burton DC, Diebo BG, Smith JS, Hostin R, Shaffrey CI, : Impact of obesity on complications, infection, and patient-reported outcomes in adult spinal deformity surgery. J Neurosurg Spine [epub ahead of print], 201526230419"},{"key":"b42","series-title":"J Spinal Disord","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1097\/00002517-199209000-00005","article-title":"Postoperative wound infections complicating adult spine surgery","volume":"5","author":"Stambough JL","year":"1992","unstructured":"Stambough JL, Beringer D: Postoperative wound infections complicating adult spine surgery. J Spinal Disord 5:277\u2013285, 1992152098610.1097\/00002517-199209000-00005"},{"key":"b43","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"991","DOI":"10.1097\/BRS.0b013e318285b219","article-title":"Decreased risk of wound infection after posterior cervical fusion with routine local application of vancomycin powder","volume":"38","author":"Strom RG","year":"2013","unstructured":"Strom RG, Pacione D, Kalhorn SP, Frempong-Boadu AK: Decreased risk of wound infection after posterior cervical fusion with routine local application of vancomycin powder. Spine (Phila Pa 1976) 38:991\u2013994, 20132332493010.1097\/BRS.0b013e318285b219"},{"key":"b44","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"2084","DOI":"10.1097\/BRS.0b013e3181ff2cb1","article-title":"Intrawound application of vancomycin for prophylaxis in instrumented thoracolumbar fusions: efficacy, drug levels, and patient outcomes","volume":"36","author":"Sweet FA","year":"2011","unstructured":"Sweet FA, Roh M, Sliva C: Intrawound application of vancomycin for prophylaxis in instrumented thoracolumbar fusions: efficacy, drug levels, and patient outcomes. Spine (Phila Pa 1976) 36:2084\u20132088, 20112130443810.1097\/BRS.0b013e3181ff2cb1"},{"key":"b45","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"3908","DOI":"10.1007\/s00586-016-4674-2","article-title":"Risk factors for surgical site infection and urinary tract infection after spine surgery","volume":"25","author":"Tominaga H","year":"2016","unstructured":"Tominaga H, Setoguchi T, Ishidou Y, Nagano S, Yamamoto T, Komiya S: Risk factors for surgical site infection and urinary tract infection after spine surgery. Eur Spine J 25:3908\u20133915, 20162734975310.1007\/s00586-016-4674-2"},{"key":"b46","series-title":"Infect Control Hosp Epidemiol","doi-asserted-by":"publisher","first-page":"623","DOI":"10.1086\/589331","article-title":"Economic burden of surgical site infections at a European university hospital","volume":"29","author":"Weber WP","year":"2008","unstructured":"Weber WP, Zwahlen M, Reck S, Feder-Mengus C, Misteli H, Rosenthal R, : Economic burden of surgical site infections at a European university hospital. Infect Control Hosp Epidemiol 29:623\u2013629, 200810.1086\/589331"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/27\/3\/article-p328.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/27\/3\/article-p328.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/27\/3\/article-p328.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T23:15:38Z","timestamp":1681600538000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/27\/3\/article-p328.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,9]]},"references-count":46,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2017.2.spine161310","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2017,9]]}}}