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Spine Infections: Variations in Incidence During the Academic Year

Banco, Stephen P. MD*; Vaccaro, Alexander R. MD*‡; Blam, Oren MD*; Eck, Jason C. MS§; Cotler, Jerome M. MD*; Hilibrand, Alan S. MD*‡; Albert, Todd J. MD*‡; Murphey, Sheila MD

Clinical Case Series

Study Design. A prospective analysis of variations in monthly spinal infection rates at a spinal cord injury center with resident and fellow involvement in surgical care.

Objective. To analyze the association between resident and fellow participation in spinal surgery and the incidence of perioperative wound infection over the academic year.

Summary of Background Data. It has been hypothesized that resident and fellow participation in surgical procedures may account for increased wound complications. Previous spinal infection studies have not addressed variations in the incidence of perioperative wound infections over the academic year.

Methods. All cases of postoperative spinal infections at a spinal cord injury center from January 1994 through December 1997 were analyzed to determine whether monthly variations reflect the changes in surgical house officer experience through the academic year.

Results. A statistically significant (P < 0.027) increase in the incidence of spinal infection was demonstrated for the month of January. No other significant variations in the monthly incidence of spinal infection existed. No significant differences were found when the data were analyzed: year-to-year (P < 0.727), season-to-season (P < 0.204), 4-month resident rotation (P < 0.061), and 6-month fellow rotation (P < 0.075).

Conclusion. A significantly higher incidence of spinal infection (10.5%) was observed for the month of January. Because January does not represent the start of a new resident or fellow rotation, there appears to be no association between the incidence of perioperative spinal wound infections and the level of experience of the surgical house officers in a regional spinal cord injury center.

From the *Department of Orthopaedic Surgery and the

†Division of Infection Control, Thomas Jefferson University, and the

‡Rothman Institute, Philadelphia, Pennsylvania, and the

§University of Health Sciences, Kansas City, Missouri.

Acknowledgment date: April 25, 2001.

Revision date: August 2, 2001.

Acceptance date: September 17, 2001.

Device status category: 1.

Conflict of interest category: 12.

Address correspondence to

Alan S. Hilibrand, MD

Rothman Institute

925 Chestnut Street, 5th Floor

Philadelphia, PA 19107

© 2002 Lippincott Williams & Wilkins, Inc.