Does minimally invasive spine surgery reduce surgical site infection rates in the trauma patient? A Southeast Asian experience.

Introduction: The trauma patient has an increased susceptibility to postoperative surgical site infection (SSI). There is a lack of studies in the literature investigating the rates of SSI in minimally invasive spine (MIS) surgery for trauma patients with associated injuries, who also require surgical intervention for thoracolumbar fractures. We aim to investigate if MIS surgery for trauma patients reduces the incidence of SSI through a less invasive approach and smaller surgical incision. Methods: A case series of 30 trauma patients who underwent MIS surgery for thoracolumbar spine fractures at our center were followed up for a year. The primary outcome measured was the presence of a postoperative SSI. Subgroup analysis was performed to determine if there were specific factors that increase the risk of developing a SSI. Results: In total, 4 (13%) patients developed postoperative SSI out of which 1 was a deep infection (3%). Subgroup analysis of both patient and surgical factors did not demonstrate statistically significant results to suggest risk factors for SSI post-MIS surgery in our patient group. Conclusion: Our series of patients did not reflect a lower incidence of SSI with MIS surgery compared to incidences in the literature. This may suggest that the increased rates of SSI in the trauma patient may not be best addressed by a minimally invasive approach alone. A multidisciplinary approach that addresses other factors - such as prolonged recumbence and a compromised immunological state may yield improved results.