Incidence and Microbiological Profile of Surgically Treated Surgical Site Infection Following Spine Surgery: A 15-Year Single-Center Surveillance Study of 10,432 Procedures (2010-2024).

Abstract

Surgical site infection following spine surgery remains a major concern. However, long-term surveillance data on its incidence and microbiological characteristics are limited. We reviewed 10,432 consecutive spine surgeries performed from 2010 to 2024. Surgical site infection was defined as a postoperative infection requiring operative irrigation and debridement. Incidence was compared between procedures with and without instrumentation. We also summarized the causative pathogens and compared the three most common pathogen groups: methicillin-susceptible Staphylococcus aureus or methicillin-susceptible Staphylococcus epidermidis, methicillin-resistant Staphylococcus aureus or methicillin-resistant Staphylococcus epidermidis, and Cutibacterium acnes. Surgical site infection was identified in 100 of 10,432 procedures (0.96%). The incidence was higher after procedures with instrumentation than after those without instrumentation (67/4,575, 1.46% vs. 33/5,857, 0.56%). Among 67 instrumented infection cases, 18 (26.9%) required partial or complete implant removal. Among instrumented SSI cases, implant removal was performed in 6 of 11 Cutibacterium acnes infections (54.5%). The interval from index surgery to SSI recognition was longest in Cutibacterium acnes infection (median, 297 days; interquartile range, 35-627 days). In this 15-year single-center study, surgically treated surgical site infection occurred in about 1% of spine surgeries and was more frequent after procedures with instrumentation. Cutibacterium acnes infection showed a longer interval from index surgery to SSI recognition in this cohort.