Pediatric Spine Foundation

Title: A Multicenter Study of the Epidemiology of Deep Surgical Site Infections in Children With Nonidiopathic Early-Onset Scoliosis Including Associated Pathogens

Authors: Anas A. Minkara, BHS, Hiroko Matsumoto, MA, Michael Glotzbecker, MD,Amer Samdani, MD, John Flynn, MD, Michael G. Vitale, MD, MPH,Lisa Saiman, MD, MPH, Childrens Spine Study Group

Journal: Spine Deformity

Date: July 01, 2019

Excerpt: This study determined the rate of deep surgical site infections (SSI) by procedure and by patient and also looked at the associated pathogens, disease-causing agents, and where they occurred. We wanted to know if where and when the pathogens occurred changed over time. If so, doctors should change their strategies to prevent infection.

Keywords: Non idiopathic scoliosis, infection, early onset scoliosis


What is the purpose of this study?

This study establishes a risk for SSI following repetitive growth-friendly surgeries in children with early-onset nonidiopathic scoliosis.  There was a 1.95% risk per procedure and a 12.6% risk per patient of infection. The study showed that the use of cefazolin, an antiobiotic to treat infection for children with nonidiopathic scoliosis was  only effective about 50% of the time (59% of gram-positive pathogens and 41% of gram-negative pathogens).


- During the study period, 593 patients underwent 5,072 growth-friendly procedures

- Deep SSIs occurred in 12.6% of patients (75/593 patients with at least one)

- Deep SSIs occurred in 1.95% prodedures (99/5,072 procedures); 49% of SSIs occurred after expansion procedures

- 89/91 cultures available (8 unavailable) had one or more bacteria identified.

Important Discussion Points

- 12.6% of patients acquired deep SSI following growth-friendly procedure; 1.95% procedures were followed by a deep SSI.

- 48% of deep SSIs occurred after surgical expansion procedures and 21% followed initial procedures.

- Cefazolin was only effective approximately  50% of the time; additional antiobiotics should be considered to prevent infection.