Practice preference and evidence analysis on topical use of tobramycin powder in lumbar spine surgery: A Multi-National AO spine survey with systematic review of the literature
Bibliographic record
Abstract
Study design: Cross-sectional study with systematic review of literature. Objective: There is an increasing interest in the topical use of antibiotics to prevent infection following spine surgery. To extend the antibiotic coverage to the gram-negative spectrum, the usage of tobramycin powder is being considered. We surveyed to analyze the current practice preference on the use of topical tobramycin in lumbar spine surgery and also aimed to analyze the literature for current evidence on the same. Methods: A multinational cross-sectional survey was conducted among AO Spine members worldwide to understand the use of topical tobramycin in 1 or 2-level open lumbar fusion surgeries. Also, an independent systematic review of four scientific databases (PubMed, Scopus, clinicaltrials.gov, Web of Science) was performed by two authors to identify relevant articles in adherence to the preferred reporting in systematic reviews and meta-analysis (PRISMA) guidelines. Studies reporting the usage of tobramycin in lumbar spine surgeries were included for analysis. Results: = 4) reported utilizing tobramycin in 1 or 2-level open lumbar fusion surgery. Upon systematic review of the literature, two studies with 484 patients were included for analysis. With the usage of tobramycin as a topical antibiotic powder, both studies noted a reduction in the incidence of infection with change in the spectrum of infective organisms. Conclusion: Topical Tobramycin is not the commonly preferred topical antibiotic to prevent SSI among spine surgeons worldwide. There is a lack of sufficient evidence to support the routine use of topical tobramycin in lumbar spine surgery.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.025 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.004 | 0.001 |
| Bibliometrics | 0.001 | 0.007 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".