gms | German Medical Science

Objective: We determined the infection rate of all neurological surgeries involving a modern two-room intraoperative MRI concept.

Methods: We included all 195 consecutive procedures that were performed at our institution with a high-field ioMRI, shared by Neurosurgery and Neuroradiology, between April 2013 and June 2016 (109 craniotomies and 86 endoscopic transsphenoidal procedures). The incidence of surgical site infections (SSI) within three months after surgery was assessed retrospectively for both operative groups.

Results: Of the 109 craniotomies, six patients (6%) developed an SSI, including one superficial SSI, two cases of bone flap osteitis, one intracranial abscess and two cases of meningitis/ventriculitis. Wound revision surgery due to infection was necessary in four patients (4%). Of the 86 transsphenoidal skull base surgeries, six patients (7%) developed an infection, including two non-CNS intranasal SSIs (3%) and four cases of meningitis (5%). Nine patients (10%) had a postoperative CSF leak. Unplanned reoperation was necessary in five transsphenoidal patients with an infection (6%). After the first year of experience, the infection rate dropped significantly to one.

Conclusion: The use of a two-room ioMRI in neurosurgical procedures requires meticulous sterile caution and seems to hold infection rates to an acceptable rate compared to other studies. The drop of infection rates in the second half of the study underlines the importance of surgical staff training after the introduction of a shared-resource ioMRI.