Relationship between Postoperative Dexamethasone Following Posterior Spinal Surgery and Surgical Site Infection

Objective:  Studies have shown that postoperative dexamethasone administration in patients in whom posterior spinal surgical interventions have been carried out reduces the postoperative pain and decreases the analgesia requirement. Our study aimed to find out whether the use of postoperative steroids in patients that had undergone posterior spinal surgical procedures led to an increased incidence of wound infections. Materials and Methods:  The medical data of 52 patients in whom posterior spinal surgical interventions had been performed were retrospectively analyzed. The patients were divided into two groups. In the first group, postoperative dexamethasone had been administered after spinal surgery, and in the second group, no postoperative dexamethasone had been given. The two groups were then compared for their association with postoperative surgical site infection. Results:  Forty-five patients were included in the group in whom postoperative dexamethasone was given. Six (13.3%) of these patients developed postoperative surgical site infections. None of the seven patients in the second group in whom no postoperative dexamethasone had been administered developed postoperative wound infection. The difference in infection rate between the two groups did not reach statistical significance (p = 0.3). Conclusion:  An infection rate of 13.3% in the group of patients in whom postoperative dexamethasone had been administered is considerably high as compared to the 1 – 2% incidence quoted in the literature for simple laminectomy procedures. A prospective study with a larger sample size is needed to accurately define the relationship between postoperative dexamethasone administration and surgical site infection following posterior spinal surgery.