IO Vancomycin Spine

Intraosseous vs. Intravenous Vancomycin Administration in Spine Surgery

The goal of this research is to learn if injecting the antibiotic vancomycin directly into the bone marrow (intraosseous) or IO) during a lumbar (spinal) fusion surgery, is as effective or better than the standard method of giving it vancomycin through a vein (intravenous) or IV) during lumbar fusion surgery.

Inclusion Criteria:

• Patient is undergoing open posterior instrumented spinal fusion (PSIF) or transforaminal lumbar interbody fusion (TLIF)
• Patient is able to give informed consent to participate on the study. LAR consents will not be utilized for this study
• Age Range >18

Exclusion Criteria:

• Previous spine surgery if surgeon deems it will affect the study
• BMI > 40
• Contraindication to receiving vancomycin, cefepime, ancef, or other standard of care pre-operative antibiotic (allergy, medical issue, etc).
• Inability to administer the IO infusion
• Refusal to participate
• Diabetes as defined as uncontrolled A1C > 7.5 and eGFR <59
• Immunocompromised or immunosuppressed patients (HIV, Hep C, ESRD, dialysis, transplant, chemo/radiation treatment in last 6 months, medications)
• No vulnerable populations