Invasive dental procedures as risk factors for postoperative spinal infection and the effect of antibiotic prophylaxis.

Aim(s) To identify invasive dental procedures as a risk factor for postoperative spinal infection and evaluate the effectiveness of antibiotic prophylaxis MATERIALS AND METHODS: We analyzed 229,335 patients who underwent spinal surgery with instrumentation from 2010 to 2017 using nationwide database. The incidence of spinal infection 2 years after surgery was determined. Invasive dental procedures as a risk factor for postoperative spinal infection and the effects of antibiotic prophylaxis during this period were also analyzed. Results A total of 15,346 patients (6.69%) were diagnosed with postoperative spinal infection. It was shown that advanced age, male sex, and a high Charlson Comorbidity Index score were risk factors for postoperative spinal infection. The risk of postoperative spinal infection did not increase following dental procedures (adjust hazard ratio [HR] 0.850; 95% confidence interval [CI], 0.793-0.912) and was not affected by antibiotics (adjust HR 1.097; 95% CI, 0.987-1.218). Patients who received dental treatment as early as 3 months after spinal surgery had the lowest risk of postoperative infection (adjust HR 0.869; 95% CI, 0.795-0.950). Conclusions Invasive dental procedure does not increase the risk of postoperative spinal infection and antibiotic prophylaxis before dental procedure was not effective in preventing spinal infection.