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Spinal implant infection

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https://www.readbyqxmd.com/read/28319551/a-contemporary-medicolegal-analysis-of-implanted-devices-for-chronic-pain-management
#1
Christopher R Abrecht, Penny Greenberg, Ellen Song, Richard D Urman, James P Rathmell
BACKGROUND: Analysis of closed malpractice claims allows the study of rare but serious complications and likely results in improved patient safety by raising awareness of such complications. Clinical studies and closed claims analyses have previously reported on the common complications associated with intrathecal drug delivery systems (IDDS) and spinal cord stimulators (SCS). This study provides a contemporary analysis of claims from within the past 10 years. METHODS: We performed a closed claims analysis for a period January 1, 2009 to December 31, 2013 for cases with pain medicine as the primary service...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28286279/management-of-esophageal-and-pharyngeal-perforation-as-complications-of-anterior-cervical-spine-surgery
#2
Moo Sung Kang, Kyung Hyun Kim, Jeong Yoon Park, Sung Uk Kuh, Dong Kyu Chin, Byung Ho Jin, Keun Su Kim, Yong Eun Cho
OBJECTIVE: To describe our experience in treating esophageal and pharyngeal perforation after anterior cervical spine surgery. METHODS: Six patients with esophageal injury and one patient with pharyngeal injury after anterior cervical spinal surgery, managed at our department between 2000 and 2015, were retrospectively analyzed. RESULTS: During the study period, seven patients (six male and one female; mean age, 45 years) presented with esophageal perforation...
March 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28266756/high-frequency-spinal-cord-stimulation-in-surgery-na%C3%A3-ve-patients-a-prospective-single-center-study
#3
Sebastian A Ahmadi, Jan Vesper, Stefan Schu, Philipp J Slotty
INTRODUCTION: A multitude of evidence supporting the beneficial effects of spinal cord stimulation (SCS) in patients suffering from chronic pain syndromes following spinal surgery has been published in the last decade. Evidence is scarce, however, for the use of high frequency SCS (HF-SCS) in the treatment of surgery naïve patients suffering from lower back pain (LBP). METHODS: From June 2014 to April 2015, we prospectively enrolled patients suffering from LBP alone or in conjunction with leg pain in a trial of HF-SCS...
March 7, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28245229/combinatory-antibiotic-therapy-increases-rate-of-bacterial-kill-but-not-final-outcome-in-a-novel-mouse-model-of-staphylococcus-aureus-spinal-implant-infection
#4
Yan Hu, Vishal Hegde, Daniel Johansen, Amanda H Loftin, Erik Dworsky, Stephen D Zoller, Howard Y Park, Christopher D Hamad, George E Nelson, Kevin P Francis, Anthony Scaduto, Nicholas M Bernthal
BACKGROUND: Management of spine implant infections (SII) are challenging. Explantation of infected spinal hardware can destabilize the spine, but retention can lead to cord compromise and biofilm formation, complicating management. While vancomycin monotherapy is commonly used, in vitro studies have shown reduced efficacy against biofilm compared to combination therapy with rifampin. Using an established in vivo mouse model of SII, we aim to evaluate whether combination therapy has increased efficacy compared to both vancomycin alone and infected controls...
2017: PloS One
https://www.readbyqxmd.com/read/28244180/a-spinal-cord-stimulation-service-review-from-a-single-centre-using-a-single-manufacturer-over-a-7-5-year-follow-up-period
#5
Simon J Thomson, Dmitry Kruglov, Rui V Duarte
BACKGROUND: Spinal cord stimulation (SCS) is a recognized management option for patients with refractory neuropathic pain. Despite randomized controlled trials reporting the effectiveness of SCS, there is a lack of long-term data reflecting usual SCS practice. The aim of this study is to present the long-term outcomes of a cohort of patients from a single centre undertaking SCS with devices from a single manufacturer. METHODS: Data were collected between January 2008 and July 2015 on 321 patients who had an SCS trial...
February 27, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28220823/treatment-of-stress-urinary-incontinence-in-men-with-spinal-cord-injury-minimally-invasive-minimally-effective
#6
J Pannek, J Wöllner
STUDY DESIGN: Retrospective chart review. OBJECTIVES: To assess the outcome of minimally invasive treatment of stress urinary incontinence with alloplastic slings in patients with neurogenic lower urinary tract dysfunction. SETTING: Switzerland. METHODS: The patient database of a tertiary urologic referral center was screened for male patients with SCI who underwent implantation of a suburethral sling between June 2009 and December 2015...
February 21, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28207621/mri-based-decision-making-of-implant-removal-in-deep-wound-infection-after-instrumented-lumbar-fusion
#7
Masahiro Kanayama, Tomoyuki Hashimoto, Keiichi Shigenobu, Fumihiro Oha, Akira Iwata, Masaru Tanaka
STUDY DESIGN: A retrospective study. OBJECTIVE: The aim of the study was to review the treatment of deep wound infection after posterior instrumented lumbar fusion, and thereby to optimize the decision-making process of implant removal or retention on the basis of magnetic resonance imaging (MRI) assessment. SUMMARY OF BACKGROUND DATA: Biofilm formed on the surface of the spinal implant prevents infiltration of antibiotics and makes the infection treatment more complicated...
March 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28186473/minimally-invasive-scoliosis-surgery-assisted-by-o-arm-navigation-for-lenke-type-5c-adolescent-idiopathic-scoliosis-a-comparison-with-standard-open-approach-spinal-instrumentation
#8
Weiguo Zhu, Weixiang Sun, Leilei Xu, Xu Sun, Zhen Liu, Yong Qiu, Zezhang Zhu
OBJECTIVE Recently, minimally invasive scoliosis surgery (MISS) was introduced for the correction of adult scoliosis. Multiple benefits including a good deformity correction rate and fewer complications have been demonstrated. However, few studies have reported on the use of MISS for the management of adolescent idiopathic scoliosis (AIS). The purpose of this study was to investigate the outcome of posterior MISS assisted by O-arm navigation for the correction of Lenke Type 5C AIS. METHODS The authors searched a database for all patients with AIS who had been treated with either MISS or PSF between November 2012 and January 2014...
February 10, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28185615/clinical-study-of-neuroregen-scaffold-combined-with-human-mesenchymal-stem-cells-for-the-repair-of-chronic-complete-spinal-cord-injury
#9
Yannan Zhao, Fengwu Tang, Guang Han, Nuo Wang, Na Yin, Bing Chen, Xianfeng Jiang, Chen Yun, Wanjun Han, Changyu Zhao, Shixiang Cheng, Zhifeng Xiao, Sai Zhang, Jianwu Dai
Regeneration of damaged neurons and recovery of sensation and motor function after complete spinal cord injury (SCI) are challenging. We previously developed a collagen scaffold, NeuroRegen scaffold, to promote axonal growth along collagen fibers and inhibit glial scar formation after SCI. When functionalized with multiple biomolecules, this scaffold promoted neurological regeneration and functional recovery in animals with SCI. In this study, eight patients with chronic complete SCI were enrolled to examine the safety and efficacy of implanting NeuroRegen scaffold with human umbilical cord mesenchymal stem cells (MSCs)...
February 9, 2017: Cell Transplantation
https://www.readbyqxmd.com/read/28168635/imaging-of-post-surgical-treatment-and-of-related-complications-in-spinal-trauma
#10
REVIEW
F Caranci, G Leone, L Ugga, E Cesarano, R Capasso, S Schipani, A Bianco, P Fonio, F Briganti, L Brunese
Spinal trauma is a devastating event with a high morbidity and mortality. The rationale of imaging is to diagnose the traumatic abnormalities and characterize the type of injury, to estimate the severity of the lesions, to evaluate the potential spinal instability. In case of spinal instability, the goals of operative treatment are decompression of the spinal cord canal and stabilization of the disrupted vertebral column. Particularly, diagnostic imaging, mainly by CT and MR, has a main role in the post-treatment evaluation...
February 6, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28156637/complications-of-intrathecal-pump-therapy-in-malignancy-related-pain
#11
Egidio Del Fabbro
102 Background: Intrathecal pumps (ITP) are used to manage severe malignancy related pain by delivering analgesics directly into the cerebrospinal fluid, in theory allowing for a reduced opioid dose and fewer complications. Although there is literature to support efficacy in patients with cancer, including improved survival, this mode of drug delivery also carries a risk of serious complications. Reports of complications in non-malignant pain suggest the risks and mortality related to ITP may be under-appreciated and that injury and liability occur with both ITP placement and ITP maintenance...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156208/image-guided-intrathecal-baclofen-pump-catheter-implantation-a-technical-note-and-case-series
#12
Shenandoah Robinson, Faith C Robertson, Hormuzdiyar H Dasenbrock, Cormac P O'Brien, Charles Berde, Horacio Padua
OBJECTIVE Medically refractory spasticity and dystonia are often alleviated with intrathecal baclofen (ITB) administration through an indwelling catheter inserted in the lumbar spine. In patients with cerebral palsy, however, there is a high incidence of concomitant neuromuscular scoliosis. ITB placement may be technically challenging in those who have severe spinal deformity or who have undergone prior instrumented thoracolumbar fusion. Although prior reports have described drilling through the lumbar fusion mass with a high-speed bur, as well as IT catheter implantation at the foramen magnum or cervical spine, these approaches have notable limitations...
February 3, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28138771/l5-corpectomy-the-lumbosacral-segmental-geometry-and-clinical-outcome-a-consecutive-series-of-14-patients-and-review-of-the-literature
#13
Martin Vazan, Yu-Mi Ryang, Julia Gerhardt, Felix Zibold, Insa Janssen, Florian Ringel, Jens Gempt, Bernhard Meyer
PURPOSE: We analyzed the lumbosacral segmental geometry and clinical outcome in patients undergoing L5 corpectomy. METHODS: Fourteen consecutive patients who underwent L5 (n = 12) or L4 + 5 (n = 2) corpectomy at our department between January 2010 and April 2015 were included. All patients underwent a baseline physical and neurologic examination on admission. The diagnostic routine included MRI and CT scans and, if possible, an upright X-ray of the lumbar spine before and after surgery...
January 31, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28116797/a-multidisciplinary-infection-control-bundle-to-reduce-the-number-of-spinal-cord-stimulator-infections
#14
Erlangga Yusuf, Sven Bamps, Bénédicte Thüer, Jan Mattheussen, Jean-Paul Ursi, Elke Del Biondo, Kris de Smedt, Raf Van Paesschen, Dirk Berghmans, Kaat Hofkens, Jef Van Schaeren, Tony van Havenbergh, Bruno Van Herendael
OBJECTIVE: To investigate the effect of a quality improvement project that resulted in an infection control bundle to reduce the number of spinal cord stimulator (SCS) infections. MATERIALS AND METHODS: The study was performed in a single center for neuromodulation from January 1, 2014, through May 31, 2016. In response to a high number of surgical site infections (SSIs) after SCS surgery, a multidisciplinary team analyzed the surgical process and developed an infection prevention bundle consisting of five items: 1) showering and decolonization for five days prior to surgery and showering in the hospital on the morning of surgery; 2) performing the SCS implantation as the first in the daily operating room (OR) program; 3) maintaining a minimal number of people in the OR; 4) providing home care nurses with a folder with SCS wound care instructions including pictures; 5) giving oral specific wound care instructions to patients...
January 24, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28059442/hydroxyapatite-cement-cranioplasty-following-translabyrinthine-approach-long-term-study-of-369-cases
#15
Peter G Volsky, Todd A Hillman, Kellen J Stromberg, Farrel J Buchinsky, Douglas A Chen, Neal M Jackson, Moisés A Arriaga
OBJECTIVE: To report the authors' experience with hydroxyapatite cement (HAC) cranioplasty and analyze the material's long-term safety and efficacy in repairing translabyrinthine skull-base defects by examining adverse events, specifically cerebrospinal fluid (CSF) leaks and surgical site infections. STUDY DESIGN: Retrospective case-control study (primary study arm); prospective cross-sectional study of patients not examined within the last 5 years (secondary arm)...
January 6, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28050444/review-of-the-management-of-peroral-extrusion-of-ventriculoperitoneal-shunt-catheter
#16
REVIEW
Rajendra Kumar Ghritlaharey
INTRODUCTION: Peroral extrusion of peritoneal part of Ventriculoperitoneal Shunt (VPS) catheter is an extremely rare complication following VPS implantation. AIM: To review the options available for the management of peroral extrusion of VPS catheter. MATERIALS AND METHODS: PubMed, Medline, PMC (PubMed Central), Embase, Google scholar databases search was performed to retrieve the published/available data relating to the peroral extrusion of VPS catheter...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28044467/magnetically-controlled-growing-rods-for-scoliosis-surgery
#17
REVIEW
Umesh Metkar, Swamy Kurra, David Quinzi, Stephen Albanese, William F Lavelle
Early onset scoliosis can be both a disfiguring as well as a life threatening condition. When more conservative treatments fail, pediatric spinal surgeons are forced to consider operative interventions. Traditionally, these interventions have involved the insertion of a variety of implants into the patient with a limited number of anchor points controlling the spine. In the past, these pediatric patients have had multiple surgeries for elective lengthening of these devices to facilitate their growth while attempting to control the scoliosis...
February 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28000413/bacteriostatic-behavior-of-surface-modulated-silicon-nitride-in-comparison-to-polyetheretherketone-and-titanium
#18
Ryan M Bock, Erin N Jones, Darin A Ray, B Sonny Bal, Giuseppe Pezzotti, Bryan J McEntire
Perioperative and latent infections are leading causes of revision surgery for orthopaedic devices resulting in significant increased patient care, comorbidities, and attendant costs. Identifying biomaterial surfaces that inherently resist biofilm adhesion and bacterial expression is an important emerging strategy in addressing implant-related infections. This in vitro study was designed to compare biofilm formation on three biomaterials commonly employed in spinal fusion surgery-silicon nitride (Si3 N4 ), polyetheretherketone (PEEK), and a titanium alloy (Ti6Al4V-ELI) -using one gram-positive and one gram-negative bacterial species...
December 21, 2016: Journal of Biomedical Materials Research. Part A
https://www.readbyqxmd.com/read/27994774/does-minimally-invasive-spine-surgery-minimize-surgical-site-infections
#19
Arvind Gopalrao Kulkarni, Ravish Shammi Patel, Shumayou Dutta
STUDY DESIGN: Retrospective review of prospectively collected data. PURPOSE: To evaluate the incidence of surgical site infections (SSIs) in minimally invasive spine surgery (MISS) in a cohort of patients and compare with available historical data on SSI in open spinal surgery cohorts, and to evaluate additional direct costs incurred due to SSI. OVERVIEW OF LITERATURE: SSI can lead to prolonged antibiotic therapy, extended hospitalization, repeated operations, and implant removal...
December 2016: Asian Spine Journal
https://www.readbyqxmd.com/read/27927549/deep-spine-infection-after-acupuncture-in-the-setting-of-spinal-instrumentation
#20
Alexandra K Callan, Jennifer M Bauer, Jeffrey E Martus
BACKGROUND: Acupuncture can be used to manage chronic pain. The most common complications related to acupuncture include pain, bruising, bleeding, or symptom exacerbation. Rarely, more serious adverse events occur, including infection, pneumothorax, septic arthritis, and peripheral nerve injury. To our knowledge, there are no reports of complications associated with acupuncture following spinal instrumentation. PURPOSE: To report a case of deep infection as a rare complication of acupuncture following posterior spinal fusion for adolescent idiopathic scoliosis...
March 2016: Spine Deformity
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