Efficacy and Safety of Topical Vancomycin for the Prevention of Surgical Site Infections in Spinal Surgery: A Meta-Analysis of Randomized Controlled Trials

Topical intraoperative application of vancomycin appears to be a safe and effective strategy for reducing the incidence of SSIs in spinal surgeries. Subgroup analyses suggest that doses ≤1g are particularly effective in reducing overall, deep, and superficial SSIs. Furthermore, the preventive effect is more pronounced in instrumented surgeries compared to noninstrumented procedures. However, due to the relatively limited pool of RCTs currently available, further high-quality, large-scale, and multicenter trials are essential to substantiate these conclusions.