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I just came back from a preop visit with a nurse from the surgery center where I am scheduled for back surgery later this week. It's supposed to be a simple decompression technique. They say I'll get antibiotics right before the operation in case of infection. How well does this work and how often do infections occur? I'm thinking about cancelling the surgery. The last thing I need right now is another medical problem.

Decompression is a surgical procedure designed to take pressure off the spinal cord and/or spinal nerve roots. The surgeon removes a portion of the bone called the lamina. The lamina forms part of back/leg pain associated with spinal stenosis (narrowing of the spinal canal) or degenerative disc disease. The use of a preoperative prophylactic (preventive) antibiotics is standard procedure. Studies show at least a 50 per cent reduction in infection with the use of this single-dose antibiotic. Surgeons also rely on sterile technique to prevent skin and deep wound infections. The use of minimally invasive spinal surgery (MISS) has also decreased the number and severity of infections. In minimally invasive spinal surgery, a tubular retractor type system is used to pass surgical instruments through a small opening in the skin. With this approach, there's less risk of transporting bacteria into the surgical site. With a smaller incision, there is less chance of wound drainage or blood pooling where infection can form. Before you cancel the surgery, talk with the surgical nurse and/or the surgeon about your concerns. Studies show the risk of infection is fairly low -- less than one per cent with minimally invasive surgery. Unless you have specific risk factors such as diabetes, obesity, or incontinence (dribbling urine), there's not much chance of an infection developing.

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