Age

18–any

Sex

ALL

Healthy volunteers

Not accepted

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

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

IO Vancomycin Spine