Intraoperative tips in Revision Spine Surgery Ruling out infection before revision lumbar spine surgery, especially in the presence of instrumentation, is an important step to improve outcomes and decrease complications. The authors recommend taking a minimum of three intraoperative cultures in all revision surgeries if an infection is suspected. Timing of Administration of antibiotics: Provided there is no concern for occult infection (normal preoperative ESR and CRP), start cefazolin, cefuroxime, clindamycin up to 60 minutes before incision and complete by the time of incision, and start vancomycin up to 120 minutes before incision and complete by the time of incision. Continuing prophylactic antibiotics for the duration that drains and catheters are in place has not been shown to reduce surgical site infections rates.