Neurosurgery

An antistaphylococcal antibiotic can decrease the incidence of infection after craniotomy. In spinal surgery, the infection rate after conventional lumbar discectomy is low, but the serious consequences of surgical site infection have led many neurosurgeons to use perioperative antibiotics. A meta-analysis concluded that antibiotic prophylaxis is beneficial in preventing infection even in low-risk spinal surgery. Infection rates are higher after prolonged spinal surgery or spinal procedures involving fusion or insertion of foreign material, and prophylactic antibiotics are often used. Studies of antimicrobial prophylaxis for implantation of permanent cerebrospinal fluid shunts have produced conflicting results.