Sebaaly A, et al. - This inquiry was set up to determine the incidence of surgical site infection (SSI) in spinal metastasis surgery and its risk factors. The mean incidence of SSI, as reported in the largest series of spinal metastasis, was 5.1%. The factors that conferred risk for SSI included smoking, higher BMI, higher number of spinal metastasis, higher ASA score, higher number of fused vertebra, intraoperative bleeding ≥ 2000 ml and neurological deterioration. In addition, only ASA ≥ 3 and operative duration ≥ 4 hours were identified as independent risk factors for this complication occurrence. SSI occurrence was found to be related to increased hospital stay, increased 30 days mortality rate and decreased survival rates.