In Brief:
It is clear that the causes of postoperative spinal infections are multifactorial and related to a complex interplay of patient and procedural influences. Because of these complexities, for any individual patient and surgical procedure, predictable infection rates likely exist that do not extrapolate to 0. Although we have identified factors associated with increased infection rates (older age, obesity, diabetes, malnutrition, higher ASA score, posterior approaches, and blood transfusions), further studies will be required to allow multifactorial risk stratification for individual patients and procedures. In addition, although numerous adjuncts have been proposed to reduce infection rates, additional safety and efficacy information will be required to make further recommendations.
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