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Spinal implant infection

Tae Hyun Kim, Jun Jae Shin, Woo Yong Lee
BACKGROUND: Percutaneous epidural neuroplasty with a Racz catheter is widely used to treat radicular pain caused by spinal stenosis or a herniated intervertebral disc. The breakage or shearing of an epidural catheter, particularly a percutaneous epidural neuroplasty catheter, is reported as a rare complication. There has been a controversy over whether surgical removal of a shorn epidural catheter is needed. Until now, only three cases related to sheared Racz neuroplasty catheters have been reported...
October 6, 2016: Journal of Medical Case Reports
Sanjiv M Baxi, Makeda L Robinson, Marie F Grill, Brian S Schwartz, Sarah B Doernberg, Catherine Liu
Little is known about the clinical presentation and outcomes associated with spinal implant infections. Here, we describe a single center's experience in a retrospective cohort of 109 individuals with spinal implant infections, including clinical, microbiological, therapeutic, and outcome data.
September 2016: Open Forum Infectious Diseases
Md Shah Alam, Kevin Phan, Rezaul Karim, Sharif Ahmed Jonayed, Hasan Khalid Md Munir, Shubhendu Chakraborty, Tashfique Alam
BACKGROUND: Tuberculosis (TB) of the spine is a common site of osseous TB, accounting for 50%-60% of cases. Spinal TB still occurs in both developed and developing countries. The diagnosis of spinal TB is difficult and it commonly presents at an advanced stage. Delays in establishing diagnosis and management result in complications such as spinal cord compression and spinal deformity. METHODS: A total of 582 patients with TB of the cervical, thoracic and lumbar spine with moderate to severe cord compression were studied...
December 2015: J Spine Surg
Mario G Zotti, Oscar P Brumby-Rendell, Ben McDonald, Tom Fisher, Christovalantis Tsimiklis, Wai Weng Yoon, Orso L Osti
BACKGROUND: Our aim was to determine whether patients derived benefit from removal of pedicle screw instrumentation for axial pain without other cause using our surgical technique and patient selection. A secondary aim was to investigate factors that were associated with poorer outcomes for this procedure as well as complication rate in this cohort. METHODS: Theater records from a single spinal surgeon's practice were reviewed to identify patients that had undergone lumbar fusion for discogenic back pain with subsequent pedicle screw instrumentation removal (Expedium, DePuy Synthes) in the preceding 3 years with a minimum of 18 months follow-up...
December 2015: J Spine Surg
Sumeet Garg, James J McCarthy, Ryan Goodwin, Joel Kolmodin, Wudbhav N Sankar, Corinna Franklin, Douglas Armstrong, David Fryzel, Susan Hassenbein, Cara Meder
BACKGROUND: The use of bone morphogenetic protein (BMP) has been associated with a number of complications in adult patients. However, this association is less established in children. The aim of this study was to evaluate the safety of BMP use in children by determining the complication rates after BMP use at multiple institutions. METHODS: In a retrospective study (2000 to 2013), the medical records of all patients who received BMP at any of the 5 institutions were reviewed...
September 3, 2016: Journal of Pediatric Orthopedics
Maura M Scanlon, Halena M Gazelka, Susan M Moeschler, Bryan C Hoelzer, W Michael Hooten, Markus A Bendel, Tim J Lamer
OBJECTIVES:  Our purpose was to determine the incidence of surgical site infection (SSI) in cancer patients receiving an intrathecal drug delivery system (IDDS) and compare that rate with the incidence of SSI in the general population receiving an IDDS or spinal cord stimulator. We attempted to describe risk factors for SSIs in cancer patients treated with IDDS in terms of exposure to cancer treatments. DESIGN:  Retrospective review. SETTING:  Large tertiary care center...
August 22, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Jamal McClendon, Timothy R Smith, Patrick A Sugrue, Sara E Thompson, Brian A O'Shaughnessy, Tyler R Koski
OBJECTIVE: To evaluate spinal implant density and proximal junctional kyphosis (PJK) in adult spinal deformity (ASD). METHODS: Consecutive ASD patients receiving >5 level fusions were retrospectively analyzed between 2007 and 2010. INCLUSION CRITERIA: ASD, elective fusions, minimum 2-year follow-up. EXCLUSION CRITERIA: Age < 18 years, neuromuscular or congenital scoliosis, cervical or cervicothoracic fusions, non-elective conditions (infection, tumor, trauma)...
August 12, 2016: World Neurosurgery
S Weckbach, B Lutz, J V Wölfle-Roos, H Reichel
Spinal infections are relatively rare entities but the incidence is significantly increasing due to the rapidly growing numbers of interventions on the spine. Primary infections of intervertebral discs (spondylodiscitis) and vertebral bodies (spondylitis) are distinguished from secondary postinterventional infections. Treatment relies primarily on either conservative or surgical management. In the absence of indications for surgery, a conservative approach is indicated when the patient is neurologically intact and the bony destruction is minimal...
October 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
EungDon Kim, MiSun Roh, SooHyang Kim, DaeHyun Jo
The sympathetic block is widely used for treating neuropathic pain such as complex regional pain syndrome (CRPS). However, single sympathetic block often provides only short-term effect. Moreover, frequent procedures for sympathetic block may increase the risk of complications. The use of epidural route may be limited by concern of infection in case of previous implantation of the spinal cord stimulation (SCS). In contrast, a continuous sympathetic block can be administered without such concerns. The continuous thoracic sympathetic block (TSGB) has been used to treat the ischemic disease and other neuropathic conditions such as postherpetic neuralgia...
2016: Pain Research & Management: the Journal of the Canadian Pain Society
Takashi Takizawa, Takahiro Tsutsumimoto, Mutsuki Yui, Hiromichi Misawa
STUDY DESIGN: .: Retrospective case series. OBJECTIVE: .: To determine relevant demographics, clinical presentations, and outcomes of surgical site infections (SSIs) following spinal instrumentation (SI) surgery caused by methicillin-resistant Staphylococcus epidermidis (MRSE). SUMMARY OF BACKGROUND DATA: .: This is the first study looking specifically at MRSE-related SSIs following SI surgery. METHODS: .: We performed a retrospective review of patients with MRSE-related SSIs from 665 consecutive cases of SI surgery performed between 2007 and 2014 at our institution...
July 14, 2016: Spine
Steven F DeFroda, Alan H Daniels, Matthew E Deren
Low back and lower extremity pain are among the most common complaints encountered by physicians. Distinguishing pain due to primary extremity pathology versus lumbar radiculopathy can be challenging. Careful physical examination and appropriate imaging with plain radiographs and advanced studies as needed are important in determining the cause of lower extremity complaints. Over-utilization of advanced imaging may reveal otherwise asymptomatic spinal pathology and can lead to an incorrect diagnosis. In patients in whom surgical intervention is being considered by a spine or arthroplasty surgeon, intra-articular or epidural steroid injections may help to reveal the underlying cause of pain via short-term symptomatic relief...
October 2016: American Journal of Medicine
John H T Waldhausen, Greg Redding, Klane White, Kit Song
PURPOSE: This report describes complications using the vertical expandable prosthetic titanium rib (VEPTR) for thoracic insufficiency syndrome (TIS) at a single center. METHODS: This is a prospective cohort evaluating 65 patients with rib-rib and rib-spine VEPTR devices for TIS placed between 10/2001 and 11/2014, for children with spinal or chest wall deformity. Patients were classified using the early onset scoliosis classification system (C-EOS). RESULTS: 65 patients are available for follow up...
June 26, 2016: Journal of Pediatric Surgery
X Zheng, Y Qiu, X Sun, B P Qian, B Wang, Y Yu, Z Z Zhu
OBJECTIVE: To evaluate the efficacy of a growth-guidance growing rod in an established porcine scoliosis model via the Cobb angle correction and the continued spinal growth. METHODS: Immature pigs (age: 6 weeks old, weight: 6-8 kg) were instrumented and tethered using a three separate incisions fashion.After considerable scoliosis was induced, the pigs were randomly assigned to an experiment group (EG) and a sham group (SG). In EG, the growing rod was implanted and the pigs were euthanized 8 weeks postoperatively; while in SG, the whole instrumentations were only removed and the pigs were followed up over a 8-week period...
June 21, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Adam Em Eltorai, Jack Haglin, Sudheesha Perera, Bielinsky A Brea, Roy Ruttiman, Dioscaris R Garcia, Christopher T Born, Alan H Daniels
Infections can hinder orthopedic implant function and retention. Current implant-based antimicrobial strategies largely utilize coating-based approaches in order to reduce biofilm formation and bacterial adhesion. Several emerging antimicrobial technologies that integrate a multidisciplinary combination of drug delivery systems, material science, immunology, and polymer chemistry are in development and early clinical use. This review outlines orthopedic implant antimicrobial technology, its current applications and supporting evidence, and clinically promising future directions...
June 18, 2016: World Journal of Orthopedics
Hwee Weng Dennis Hey, Hey Hwee Weng Dennis, Tan Chuen Seng, Dale Fisher, Anupama Vasudevan, Liu Ka-Po Gabriel, Joseph Thambiah, Naresh Kumar, Lau Leok Lim, Wong Hee Kit, Paul Anantharajah Tambyah
STUDY DESIGN: A retrospective, cohort study of 84 patients with deep spine infection managed at a major tertiary hospital over 14 years, with a minimum follow-up of 2 years. OBJECTIVE: To determine the role of instrumentation in spines with deep infection SUMMARY OF BACKGROUND DATA.: It is often believed that implants should not be inserted in patients with deep spine infection because of the risk of persistent or recurrent infection. However, there are often concerns about spinal stability and a paucity of evidence to guide clinical practice in this field...
June 21, 2016: Spine
Ilker Keskiner, Ahmet Aydogdu, Seda Ozturan
Poly-ether-ether-ketone (PEEK) is a radiolucent material commonly used in spinal surgery as a substitute for titanium. It is also used as a dental implant material, however, literature related to this application of PEEK is very limited. This case report presents the surgical removal of PEEK-derived basal dental implants due to failure of osseointegration. A 58-year-old female referred our clinic with complaints of mobility and pain related to PEEK-derived implants. The removal of these implants was planned due to infection after intraoral and radiographic examination...
June 21, 2016: Journal of Oral Implantology
Pamela Kantelhardt, Alf Giese, Sven R Kantelhardt
ISSUE: Recently, quality tools have been promoted to improve patient safety and process efficiency in healthcare. While surgeons primarily focused on surgical issues, like infection rates or implant design, we introduced pre-admission and preoperative checklists in the early 2000s. INITIAL ASSESSMENT: To assess the efficiency of these tools in a neurosurgical department, we performed a survey of all spinal instrumentation patients operated in 2011 (n = 147)...
September 2016: International Journal for Quality in Health Care
Naureen Keric, David J Eum, Feroz Afghanyar, Izabela Rachwal-Czyzewicz, Mirjam Renovanz, Jens Conrad, Dominik M A Wesp, Sven R Kantelhardt, Alf Giese
Robot-assisted percutaneous insertion of pedicle screws is a recent technique demonstrating high accuracy. The optimal treatment for spondylodiscitis is still a matter of debate. We performed a retrospective cohort study on surgical patients treated with pedicle screw/rod placement alone without the application of intervertebral cages. In this collective, we compare conventional open to a further minimalized percutaneous robot-assisted spinal instrumentation, avoiding a direct contact of implants and infectious focus...
June 9, 2016: Journal of Robotic Surgery
John R Dimar, David T Endriga, Leah Y Carreon
Spinal cord stimulators (SCSs) have long been in use as a modality for the management of numerous pain pathologies. Along with commonly anticipated morbidities such as displacement, failure (due to fracture or breakage), or infection, there have also been rare but well-documented complications of fibrous scarring, resulting in spinal cord compression. This is the first known case that demonstrates osteolysis and bony destruction of the vertebrae adjacent to the SCS along with the foreign-body granulomatous reaction...
June 2016: Journal of Neurological Surgery Reports
Joseph Rabi, Magdalena Anitescu
UNLABELLED: The objective of this manuscript was to report a case of a patient with extruded pulse generator 3 years after implantation of a spinal cord stimulator system.With the increasing incidence of chronic pain, spinal cord stimulation (SCS) is becoming more commonly utilized by pain physicians. SCS is a generally safe intervention with minimal adverse effects; however, there are risks of complications which practitioners should be aware of prior to and after placement of the SCS...
May 2016: Pain Physician
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