Prophylactic Use of Antibiotics for Fever After Drainage Removal Following a Dural Tear During Lumbar Spinal Surgery: A Retrospective Study

BACKGROUND Dural tear and subsequent cerebrospinal fluid leakage are frequent complications during lumbar spine surgery. This retrospective study aimed to investigate the risk factors and the use of prophylactic antibiotics in patients with fever after drainage removal (FDR) following lumbar dural tear during lumbar spinal surgery. MATERIAL AND METHODS The authors retrospectively analyzed 2812 patients who underwent different spinal surgical procedures from January 2015 to December 2017. The basic information of patients was obtained to analyze the risk factors of dural tear and FDR. The patients were divided into 5 groups according to their antibiotic strategies for FDR (no antibiotics, ceftriaxone, vancomycin, ceftriaxone+vancomycin, other antibiotics). Body temperature, laboratory test results, and pathogen profiles were collected for analysis. RESULTS There were 326 cases diagnosed as dural tear, including 198 cases of FDR. Sex, age, type of disease, and previous lumbar surgery played significant roles in the dural tear rate (P<0.05). Patients older than 60 years old had a higher incidence of FDR after dural tear (P<0.05). There was no significant difference in the incidence of surgical site infection among the various treatment groups (P>0.05). CONCLUSIONS Age has obvious effect on dural tear and FDR, whereas sex, revision surgery, primary diagnosis, and procedure type only affect the rate of dural tear. The prophylactic use of antibiotics has no effect on the incidence of surgical site infection when fever after drainage removal occurred in patients with dural tear.