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Spinal implant infection

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https://www.readbyqxmd.com/read/28922615/the-impact-of-incorporating-antimicrobials-into-implant-surfaces
#1
N J Hickok, I M Shapiro, A F Chen
With the increase in numbers of joint replacements, spinal surgeries, and dental implantations, there is an urgent need to combat implant-associated infection. In addition to stringent sterile techniques, an efficacious way to prevent this destructive complication is to create new implants with antimicrobial properties. Specifically, these implants must be active in the dental implant environment where the implant is bathed in the glycoprotein-rich salivary fluids that enhance bacterial adhesion, and propagation, and biofilm formation...
September 1, 2017: Journal of Dental Research
https://www.readbyqxmd.com/read/28915961/short-stem-total-hip-arthroplasty-potential-explanations-for-persistent-post-surgical-thigh-pain
#2
Isabel A C Baert, Enrique Lluch, Francis Van Glabbeek, Rudy Nuyts, Salim Rufai, Joanna Tuynman, Filip Struyf, Mira Meeus
Short stem uncemented femoral implants were developed with the aim of preserving proximal bone stock for future revisions, improving biomechanical reconstruction, aiding insertion through smaller incisions and potentially decreasing or limiting the incidence of thigh pain. Despite all the advantages of short stem designs, it remains unclear whether they are able to limit post-surgical thigh pain. In patients with short stem hip arthroplasty and persistent thigh pain, it is of the utmost importance to understand the potential etiologies of this chronic pain for selecting the appropriate treatment strategy...
September 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28914835/-surgical-treatment-of-pain-syndrome-in-lumbar-spine-in-patients-with-obesity
#3
A G Aganesov, E G Gemdzhyan, A L Kheilo, K P Mikaelyan, M M Alexanyan
AIM: To analyze the reduction of pain severity, time of surgery, intraoperative blood loss, incidence of unintentional lesion of dura mater, infectious complications and hospital-stay after lumbar microdiscectomy. MATERIAL AND METHODS: The study included 104 patients aged 24-58 years (37 men and 67 women, mean age 45 years) who underwent lumbar microdiscectomy within January 2015 - June 2016. The main and control groups consisted of 48 and 56 patients with and without obesity respectively...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28913559/risk-factors-for-implant-removal-after-spinal-surgical-site-infection
#4
Naoya Tsubouchi, Shunsuke Fujibayashi, Bungo Otsuki, Masanori Izeki, Hiroaki Kimura, Masato Ota, Takeshi Sakamoto, Akira Uchikoshi, Shuichi Matsuda
PURPOSE: Few studies have investigated the risk factors for implant removal after treatment for spinal surgical site infection (SSI). Therefore, there is no firmly established consensus for the management of implants. We aimed to investigate the incidence and risk factors for implant removal after SSI managed with instrumentation, and to examine potential strategies for avoiding implant removal. METHODS: Following a survey of seven spine centers, we retrospectively reviewed the records of 55 patients who developed SSI and were treated with reoperation, out of 3967 patients who had spinal instrumentation between 2003 and 2012...
September 14, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28901641/a-temporary-vs-permanent-anchored-percutaneous-lead-trial-of-spinal-cord-stimulation-a-comparison-of-patient-outcomes-and-adverse-events
#5
Thomas Simopoulos, Sanjiv Sharma, Moris Aner, Jatinder S Gill
OBJECTIVES: A trial of spinal cord stimulation (SCS) is a prerequisite to determine efficacy of the therapy prior to placement of a permanent implanted system. A trial may be conducted employing a percutaneously placed temporary cylindrical lead or via a permanently anchored cylindrical lead placed and subsequently secured via open surgical method. There has been little investigation comparing the two methods of trial. This study is a comparative analysis of the two methods both for prediction of success as well as associated morbidity...
September 13, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28878518/on-demand-antibiotic-eluting-microchip-for-implanted-spinal-screws
#6
Adam E M Eltorai
OBJECTIVE: Surgical instrumentation of the spine is susceptible to infection. Intravenous antibiotics is a current mainstay of treating infection; however penetrating the bacterial biofilm and directly targeting the source of the infection is challenging. METHODS: Using multiple reservoirs of discrete drug doses, microchips represent a new technology capable of on-demand drug release over long periods of time. RESULTS: A novel solution of integrating vancomycin-eluting microchips into pedicle screws in order directly target and treat spinal infections is proposed...
December 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28875558/spinal-cord-stimulator-explantation-motives-for-removal-of-surgically-placed-paddle-systems
#7
Derrick A Dupré, Nestor Tomycz, Donald Whiting, Michael Oh
BACKGROUND: Despite requiring successful trials prior to implantation, spinal cord stimulation (SCS) systems for pain are often later removed. Removing surgically implanted hardware subjects patients to the risks and discomfort of a second surgery, threatens the cost-effectiveness of SCS, and limits the perceived durability of SCS technology for pain problems. OBJECTIVE: To investigate patterns of reasons given among patients who underwent SCS explant surgery (SCSES)...
September 5, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28870838/comparison-of-s2-alar-and-traditional-iliac-screw-pelvic-fixation-for-pediatric-neuromuscular-deformity
#8
Mark C Lee, Casey Jarvis, Matthew J Solomito, Jeffrey Thomson
Background Context Many pelvic fixation options exist for posterior spinal fusion of pediatric neuromuscular scoliosis, including standard iliac screws (SIS) or a more recently introduced S2-Alar (S2A) technique. However, little data exists comparing the clinical and radiographic outcomes of these techniques. Purpose Identify differences in clinical and radiographic outcomes for pediatric neuromuscular scoliosis patients treated with standard iliac screw (SIS) or S2-Alar (S2-A) pelvic fixation. Study Design/Setting Retrospective cohort study at a pediatric orthopaedic clinic...
September 1, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28833931/rate-of-complications-following-spinal-cord-stimulation-paddle-electrode-removal
#9
Andres L Maldonado-Naranjo, Leonardo A Frizon, Navin C Sabharwal, Roy Xiao, Olivia Hogue, Darlene A Lobel, Andre G Machado, Sean J Nagel
OBJECTIVE: Spinal cord stimulation (SCS) is a safe, reversible surgical treatment for complex regional pain syndrome and failed back surgery syndrome refractory to conventional medical management. Paddle electrodes are routinely used for the permanent implant because of the reduced risk of migration, lower energy requirements, and expanded coverage options. The risks associated with paddle lead removal are not well defined in the literature. METHODS: We retrospectively reviewed the outcomes of all patients at the Cleveland Clinic who underwent removal of SCS paddle electrodes between 2009 and 2016...
August 22, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28819694/thoracic-corpectomy-for-neoplastic-vertebral-bodies-using-a-navigated-lateral-extracavitary-approach-a-single-center-consecutive-case-series-technique-and-analysis
#10
Sebastian Hartmann, Christoph Wipplinger, Anja Tschugg, Pujan Kavakebi, Alexander Örley, Pierre Pascal Girod, Claudius Thomé
Thoracic myelopathy is often caused by vertebral body fractures resulting from neoplastic conditions, traumatic events, or infectious diseases. One of the preferred procedures for treating it is the lateral extracavitary approach (LECA) with single-level or multilevel decompressive corpectomy and reconstruction. The aim of this retrospective study was to analyze the thoracic lateral extracavitary approach with corpectomy using vertebral body replacement systems (VBR-S) and dorsal reconstruction. Twenty-four patients with metastatic or primary lesions of thoracic vertebrae T2-T12 underwent spinal decompression and ventral column reconstruction with correction of spinal deformity via a LECA...
August 17, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28777282/intrawound-vancomycin-powder-associated-with-reduced-surgical-site-infection-in-rib-based-distraction-surgery
#11
Justin M Haller, John A Heflin, David A Hulet, Qian Ding, Angela P Presson, John T Smith
BACKGROUND: Despite clinical reports of improved pulmonary function and reduced spinal deformity with rib-based distraction surgery in early-onset scoliosis (EOS) patients, infection remains a common complication, reported as high as 32% in some studies. The purpose of this study was to evaluate intrawound vancomycin powder in pediatric patients managed with rib-based distraction for EOS. METHODS: This was a single institution retrospective cohort study of EOS patients treated with rib-based distraction...
August 2, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28768786/posterior-spinal-fusion-for-adolescent-idiopathic-scoliosis-using-a-convex-pedicle-screw-technique-a-novel-concept-of-deformity-correction
#12
A I Tsirikos, G Mataliotakis, N Bounakis
AIMS: We present the results of correcting a double or triple curve adolescent idiopathic scoliosis using a convex segmental pedicle screw technique. PATIENTS AND METHODS: We reviewed 191 patients with a mean age at surgery of 15 years (11 to 23.3). Pedicle screws were placed at the convexity of each curve. Concave screws were inserted at one or two cephalad levels and two caudal levels. The mean operating time was 183 minutes (132 to 276) and the mean blood loss 0...
August 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28761521/safety-and-efficacy-of-spinal-loop-rectangle-and-sublaminar-wires-for-osteoporotic-vertebral-compression-fracture-fixation
#13
Sanganagouda Shivanagouda Patil, Shekhar Yashwant Bhojaraj, Abhay Madhusudan Nene
BACKGROUND: Natural history of osteoporotic vertebral compression fractures (OVCFs), that is, collapse, loads the rigid pedicle screw rod construct in the absence of anterior column reconstruction, often leading to implant back outs. Semi rigid spinal loop rectangle and sublaminar wire construct allows controlled axial collapse and does not require anterior column reconstruction. MATERIALS AND METHODS: This is a retrospective study of 50 consecutive patients of OVCFs...
July 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28726312/spinal-cord-stimulator-related-infections-findings-from-a-multicenter-retrospective-analysis-of-2737-implants
#14
Markus A Bendel, Travis O'Brien, Bryan C Hoelzer, Timothy R Deer, Thomas P Pittelkow, Shrif Costandi, David R Walega, Gerges Azer, Salim M Hayek, Zhen Wang, Jason S Eldrige, Wenchun Qu, Joshua M Rosenow, Steven M Falowski, Stephanie A Neuman, Susan M Moeschler, Catherine Wassef, Christopher Kim, Tariq Niazi, Taher Saifullah, Brian Yee, Chong Kim, Christine L Oryhan, Daniel T Warren, Imanuel Lerman, Ruben Mora, Michael Hanes, Thomas Simopoulos, Sanjiv Sharma, Chris Gilligan, Warren Grace, Timothy Ade, Nagy A Mekhail, John P Hunter, Daniel Choi, Deborah Y Choi
INTRODUCTION: Surgical site infection is a potential complication of spinal cord stimulator (SCS) implantation. Current understanding of the epidemiology, diagnosis, and treatment of these infections is based largely on small clinical studies, many of which are outdated. Evidence-based guidelines for management of SCS-related infections thus rely instead on expert opinion, case reports, and case series. In this study, we aim to provide a large scale retrospective study of infection management techniques specifically for SCS implantation...
July 20, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28705257/single-stage-transforaminal-decompression-debridement-interbody-fusion-and-posterior-instrumentation-for-lumbosacral-brucellosis
#15
Yakefu Abulizi, Wei-Dong Liang, Aikeremujiang Muheremu, Maierdan Maimaiti, Wei-Bin Sheng
BACKGROUND: Spinal brucellosis is a less commonly reported infectious spinal pathology. There are few reports regarding the surgical treatment of spinal brucellosis in existing literature. This retrospective study was conducted to determine the effectiveness of single-stage transforaminal decompression, debridement, interbody fusion, and posterior instrumentation for lumbosacral spinal brucellosis. METHODS: From February 2012 to April 2015, 32 consecutive patients (19 males and 13 females, mean age 53...
July 14, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28692571/efficacy-of-target-drug-delivery-and-dead-space-reduction-using-antibiotic-loaded-bone-cement-for-the-treatment-of-complex-spinal-infection
#16
Soichiro Masuda, Shunsuke Fujibayashi, Bungo Otsuki, Hiroaki Kimura, Shuichi Matsuda
STUDY DESIGN: A retrospective study. OBJECTIVES: We have treated complex cases of surgical site infection (SSI) successfully using antibiotic-loaded bone cement to avoid the need for implant removal. In the present study, we describe a new treatment option for SSI. SUMMARY OF BACKGROUND DATA: Although there are several treatment options for SSI after spinal surgery involving instrumentation, several types of problems may arise and are difficult to cure...
July 7, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28671743/a-case-of-spinal-cord-stimulator-recharging-interruption-in-wound-healing
#17
Semih Gungor, Rohit Aiyer
OBJECTIVES: To illustrate the obstacles and problems with electrical fields (EFs) in treatment and management of skin wounds. Unlike the literature that gives evidence for EF promoting wound healing, there is relatively little research to illustrate the interference of wound healing with EFs. MATERIALS AND METHODS: This is a case report of a patient who underwent spinal cord stimulator implantation, and presented with delayed wound healing postoperatively. Postoperative workup for infection was negative...
July 3, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28670411/polymicrobial-and-monomicrobial-infections-after-spinal-surgery-a-retrospective-study-to-determine-which-infection-is-more-severe
#18
Shaoqiang Liu, Qiang Qi, Zhongqiang Chen, Ning Liu, Zhaoqing Guo, Chuiguo Sun, Weishi Li, Yan Zeng, Zhongjun Liu
STUDY DESIGN: A retrospective clinical review. PURPOSE: To investigate the difference in clinical manifestations and severity between polymicrobial and monomicrobial infections after spinal surgery. OVERVIEW OF LITERATURE: Surgical site infections (SSIs) after spinal surgery are a major diagnostic and therapeutic challenge for spinal surgeons. Polymicrobial infections after spinal surgery seem to result in poorer outcomes than monomicrobial infections because of complementary resistance to antibiotics...
June 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/28658132/emergency-1-stage-anterior-approach-for-cervical-spine-infection-complicated-by-epidural-abscess
#19
Haoxi Li, Zhaoxiong Chen, Zhiyao Yong, Xinhua Li, Yufeng Huang, Desheng Wu
It was a retrospective analysis.The aim of the study was to explore the safety and reliability of emergency 1-stage radical debridement and reconstruction using titanium mesh filled with autologous bone for patients with cervical spine infection complicated by epidural abscess.At present, cervical spine infection complicated by epidural abscess is known as a severe spine disease. Recently, case report of this disease is showing quite an increasing tendency, particularly in economically undeveloped areas and countries...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28631069/-s2-ala-iliac-screws-for-extended-pelvic-fixation-in-longer-lumbar-instrumentations-description-of-a-freehand-technique
#20
REVIEW
F Lattig, S Weckbach
OBJECTIVE: To reduce the rate of implant failures at the lumbosacral junction in polysegmental lumbar fusions. INDICATIONS: Spinal fusion with deformity correction including L5/S1, revision surgery for pseudoarthrosis L5/S1, screw pull-out and pedicle fractures in S1, and S1/S2 fractures after polysegmental fusions. CONTRAINDICATIONS: Osteosynthesis of complex pelvic ring fractures, tumors of the ilium. Relative contraindication: infection, to avoid contamination of the iliosacral joint...
August 2017: Operative Orthopädie und Traumatologie
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