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Spine infection

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https://www.readbyqxmd.com/read/29239893/switch-from-tenofovir-disoproxil-fumarate-combination-to-dolutegravir-plus-rilpivirine-improves-parameters-of-bone-health
#1
Grace A Mccomsey, Sergio Lupo, David Parks, Mónica Coronado Poggio, Joseph De Wet, Lesley P Kahl, Kostas Angelis, Brian Wynne, Kati Vandermeulen, Martin Gartland, Michael Cupo, Michael Aboud
OBJECTIVE: Bone mineral density (BMD) loss, a risk factor for osteoporosis, has been attributed to HIV infection and antiretroviral therapy (ART), including regimens containing tenofovir disoproxil fumarate. DESIGN: Study 202094 is an open-label, parallel-group, sub-study of the phase III SWORD-1 and SWORD-2 studies (ClincialTrials.gov identifier, NCT02478632). METHODS: HIV-1-infected adults with HIV-1 RNA < 50 copies per mL who received ART containing tenofovir disoproxil fumarate for ≥6 months were randomized to receive dolutegravir+rilpivirine or continue current ART regimen...
December 12, 2017: AIDS
https://www.readbyqxmd.com/read/29238641/complication-rates-in-posterior-lumbar-interbody-fusion-plif-surgery-with-human-bone-morphogenetic-protein-2-medicare-population
#2
Raed Alobaidaan, Jeremiah R Cohen, Elizabeth L Lord, Zorica Buser, S Tim Yoon, Jim A Youssef, Jong-Beom Park, Darrel S Brodke, Jeffrey C Wang, Hans-Joerg Meisel
Study Design: Retrospective cohort study among Medicare beneficiaries who underwent posterior lumbar interbody fusion (PLIF) surgery. Objective: To identify the complication rates associated with the use of bone morphogenetic protein 2 (BMP2) in PLIF. Human BMP2 is commonly used in the "off-label" manner for various types of spine fusion procedures, including PLIF. However, recent studies have reported potential complications associated with the recombinant human BMP2 (rhBMP2) use in the posterior approach...
December 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29238639/the-use-of-vacuum-dressings-for-dead-space-management-in-deep-surgical-site-infections-allows-implant-and-bone-graft-retention
#3
James P Watt, Robert N Dunn
Study Design: Retrospective, descriptive study. Objectives: Managing early surgical site infection following elective lumbar spine surgery remains a challenge with controversy regarding retention of instrumentation and bone graft. Wound closure may also pose considerable challenges. We aim to report on our method of managing deep surgical site infections complicating elective spine surgery with surgeon assembled deep vacuum dressings. Identification of causative organisms with their sensitivities was a secondary objective...
December 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29238110/intrawound-vancomycin-powder-as-the-prophylaxis-of-surgical-site-infection-after-invasive-spine-surgery-with-a-high-risk-of-infection
#4
Tetsuro Hida, Kei Ando, Kazuyoshi Kobayashi, Kenyu Ito, Mikito Tsushima, Akiyuki Matsumoto, Masayoshi Morozumi, Satoshi Tanaka, Masaaki Machino, Kyotaro Ota, Shunsuke Kanbara, Sadayuki Ito, Yoshihiro Nishida, Naoki Ishiguro, Shiro Imagama
Surgical site infections (SSIs) are one of the most serious complications in spine surgery. We investigated the efficacy of locally administered vancomycin (VCM) powder for prophylaxis on SSI after invasive spine surgery. We retrospectively studied 174 consecutive patients who underwent spine surgery. In patients of the VCM group (n = 81), VCM powder was administered in the wound before closing wound. Patients who did not receive VCM treatment were set as a control group (n = 93). We compared the patients' background, operation time, intraoperative blood loss, usage of implants, presence of deep SSI, and side effects between the two groups...
November 2017: Nagoya Journal of Medical Science
https://www.readbyqxmd.com/read/29235394/follow-up-magnetic-resonance-imaging-in-spine-infection-details-which-matter-most
#5
Genevieve L McKew, Craig A Buchan, Elizabeth Thompson, Colin Macleod
No abstract text is available yet for this article.
December 13, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/29234660/monosegmental-combined-anterior-posterior-instrumentation-for-the-treatment-of-a-severe-lumbar-tuberculous-spondylodiscitis-case-report-and-literature-review
#6
Petracchi Matias, Camino Willhuber Gaston, Tripodi Maria, Bassani Julio, Gruenberg Marcelo, Sola Carlos
Spinal tuberculosis (Pott disease) can produce severe deformities when it is not properly treated. Long instrumentations through single or combined double approaches are usually required to prevent and correct the deformity. The authors present a case of severe deformity secondary to tuberculous spondylodiscitis in the lumbar spine treated with a monosegmental instrumentation through a double approach in a patient with idiopathic scoliosis. Deformity correction and infection resolution through debridement and arthrodesis is observed after one year of follow-up...
November 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/29227322/no-clear-benefit-of-chlorhexidine-use-at-home-before-surgical-preparation
#7
Melvin Chugh Makhni, Kolawole Jegede, Joseph Lombardi, Susan Whittier, Prakash Gorroochurn, Ronald A Lehman, K Daniel Riew
INTRODUCTION: Several studies have evaluated the efficacy of home use of chlorhexidine before surgery to reduce bacterial colonization. However, these studies have provided conflicting evidence about the potential efficacy of this strategy in decreasing bacterial loads and infection rates across surgical populations, and no prior study has analyzed the benefit of this intervention before spine surgery. We prospectively analyzed the effectiveness of chlorhexidine gluconate wipes for decreasing bacterial counts on the posterior neck...
December 11, 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29224267/-clinical-outcomes-of-cervical-disc-herniation-treated-by-posterior-percutaneous-endoscopic-cervical-discectomy
#8
B L Chen, Y J Li, Y P Lin, Y X Du, S Zhao, G Y Su
Objective: To evaluate the clinical outcomes of posterior percutaneous endoscopic cervical discectomy (PPECD) for cervical disc herniation. Methods: A total of 23 patients who underwent PPECD for cervical disc herniation at Department of Spine Surgery, Guangdong Provincial Hospital of Chinese Medicine from August 2014 to April 2016 were reviewed. The mean age of the 17 males and 6 females was 49.5 years (range from 31 to 61 years). All patients had unilateral upper limb radiating symptoms, 13 patients with right upper limb radiating pain and 10 patients with left upper limb radiation pain, 17 patients with neck pain symptoms...
December 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29216848/anterior-sacral-meningocele-infected-with-fusobacterium-in-a-patient-with-recently-diagnosed-colorectal-carcinoma-a-case-report
#9
Anne K Braczynski, Marc A Brockmann, Torben Scholz, Jan-Philipp Bach, Jörg B Schulz, Simone C Tauber
BACKGROUND: Anterior sacral meningoceles are rare, and usually occur with other malformations of the posterior lower spine. While these are more frequently reported in pediatric cohorts, we report a case in an elderly woman. CASE PRESENTATION: We report on a 71 year-old woman with a recently diagnosed colorectal adenocarcinoma who presented with a severe bacterial meningitis. The cerebrospinal fluid cell count revealed a pleocytosis of 80,000 cells/μl and a severe disturbance of the blood-brain-barrier...
December 8, 2017: BMC Neurology
https://www.readbyqxmd.com/read/29215499/post-operative-emergency-department-utilization-and-hospital-readmission-after-cervical-spine-arthrodesis-rates-trends-causes-and-risk-factors
#10
Peter B Derman, Lukas P Lampe, Ting Jung Pan, Stephan N Salzmann, Janina Kueper, Federico P Girardi, Stephen Lyman, Alexander P Hughes
STUDY DESIGN: Retrospective state database analysis. OBJECTIVE: To quantify the 30-day and 90-day emergency department (ED) utilization and inpatient readmission rates after primary cervical arthrodesis, to stratify these findings by surgical approach and to describe risk factors and conditions precipitating these events. SUMMARY OF BACKGROUND DATA: Limited data exist on ED utilization and hospital readmission rates after cervical spine arthrodesis...
December 5, 2017: Spine
https://www.readbyqxmd.com/read/29208475/cortical-bone-trajectory-screws-fixation-in-lumbar-adjacent-segment-disease-a-technique-note-with-case-series
#11
Chao-Hsuan Chen, Hsieng-Ming Huang, Der-Cherng Chen, Chih-Ying Wu, Han-Chun Lee, Der-Yang Cho
Lumbar adjacent segment disease after lumbar fusion surgery often requires surgical intervention. However, subsequent surgical treatment often needs to expose and remove all of the previous instruments. This additional surgery leads to significant post-operative pain, muscular fibrosis, poor wound healing and infection, etc. From October 2015 to March 2016, we collected six cases underwent cortical bone trajectory screws fixation with minimal invasive inter-body cage fusion for lumbar adjacent segment disease...
December 2, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29206327/pharyngeal-perforation-after-anterior-cervical-spine-surgery-treated-by-transoral-endoscopic-surgery
#12
Julio Rama-López, Meritxell Tomás-Fernandez, César García-Garza, Milton Martínez-Madrigal
BACKGROUND: Anterior cervical fixation has been used since 1967 for multiple pathologies like traumatism, compressive myelopathy, or spinal infections. METHODS: We report the case of a patient who had undergone cervical spine surgery 10 years previously and presented to our clinic with a pharyngeal fistula due to surgical screw displacement that was treated by transoral endoscopic surgery. RESULTS: The immediate postoperative period occurred without incidence and complete odynophagia resolution...
December 5, 2017: Head & Neck
https://www.readbyqxmd.com/read/29201144/length-of-stay-costs-and-complications-in-lumbar-disc-herniation-surgery-by-standard-plif-versus-a-new-dynamic-interspinous-stabilization-technique
#13
Manuel Segura-Trepichio, David Candela-Zaplana, José Manuel Montoza-Nuñez, Antonio Martin-Benlloch, Andreu Nolasco
Background: The number of lumbar spine surgeries has been increasing during the last 20 years, which also leads to an increase in hospital costs and complications related to surgery. Therefore, there is a greater concern about the costs and safety of the techniques and implants used. Methods: Patients (aged from 18 to 50 years) presenting with lumbago /sciatica (ICD-10-CM M54.3, M54.4) due to lumbar disc herniation lasting more than 12 weeks, were included. Patients with disc herniation larger than size-2 or size-3 according to the MSU Classification were eligible for participation...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/29200173/medical-malpractice-claims-following-incidental-durotomy-due-to-spinal-surgery
#14
Wesley M Durand, Adam E M Eltorai, Govind Shantharam, J Mason DePasse, Eren O Kuris, Alicia E Hersey, Mark A Palumbo, Alan H Daniels
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: Analyze medical malpractice verdicts and settlements associated with incidental durotomy. SUMMARY OF BACKGROUND DATA: Incidental durotomy is a common complication of spine surgery. While most intraoperative dural tears are repaired without sequelae, persistent CSF leak, infection, or neurological injury can yield adverse outcomes. The medicolegal implications of incidental durotomy are poorly understood...
December 4, 2017: Spine
https://www.readbyqxmd.com/read/29192880/negative-pressure-dressing-management-of-recurrent-postoperative-epidural-hematoma-and-uncontrollable-intraoperative-hemorrhage-in-posterior-spine-surgery-report-of-4-cases
#15
Kenneth C Foxx, Addisu Mesfin, Robert Molinari
There is a paucity of literature describing the management of recurrent symptomatic postoperative epidural hematoma or uncontrollable intraoperative hemorrhage in posterior spine surgery. Traditional management with hematoma evacuation and wound closure over suction drains may not be effective in certain cases, and it can lead to recurrence and neurological injury. The authors report 3 cases of recurrent symptomatic postoperative epidural hematoma successfully managed with novel open-wound negative-pressure dressing therapy (NPDT), as well as 1 case of uncontrollable intraoperative hemorrhage that was primarily managed with the same technique...
December 1, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29191488/introduction-to-neuroimaging
#16
REVIEW
Elizabeth George, Jeffrey P Guenette, Thomas C Lee
Primary care physicians are often tasked with evaluating neurologic symptoms and imaging plays a critical role in neurologic diagnoses. Neuroradiology routinely employs advanced imaging modalities and hence, determination of the appropriate imaging test and interpretation of findings in the clinical context can understandably be overwhelming. In this review article, we introduce resources that can guide physicians in the selection of neuroimaging tests and summarize guidelines on contrast agent administration...
November 27, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/29191104/does-prior-spine-surgery-or-instrumentation-affect-surgical-outcomes-following-3-column-osteotomy-for-correction-of-thoracolumbar-deformities
#17
Darryl Lau, Andrew K Chan, Vedat Deverin, Christopher P Ames
OBJECTIVE Adult spinal deformity (ASD) develops in the setting of asymmetrical arthritic degeneration, and can also be due to iatrogenic causes, such as prior surgery. Many patients who present with ASD have undergone prior spine surgery with instrumentation. Unfortunately, contemporary studies that evaluate the effect of prior surgery or instrumentation on perioperative outcomes, readmission rates, and need for reoperation are lacking. METHODS All ASD patients who underwent a 3-column osteotomy performed by the senior author at the authors' institution for correction of thoracolumbar spinal deformity between 2006 and 2016 were identified...
December 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29191099/an-assessment-of-frailty-as-a-tool-for-risk-stratification-in-adult-spinal-deformity-surgery
#18
Emily K Miller, Brian J Neuman, Amit Jain, Alan H Daniels, Tamir Ailon, Daniel M Sciubba, Khaled M Kebaish, Virginie Lafage, Justin K Scheer, Justin S Smith, Shay Bess, Christopher I Shaffrey, Christopher P Ames
OBJECTIVE The goal of this study was to analyze the value of an adult spinal deformity frailty index (ASD-FI) in preoperative risk stratification. Preoperative risk assessment is imperative before procedures known to have high complication rates, such as ASD surgery. Frailty has been associated with risk of complications in trauma surgery, and preoperative frailty assessments could improve the accuracy of risk stratification by providing a comprehensive analysis of patient factors that contribute to an increased risk of complications...
December 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29189567/transfusion-of-red-blood-cells-stored-more-than-28-days-is-associated-with-increased-morbidity-following-spine-surgery
#19
Taylor E Purvis, C Rory Goodwin, Camilo A Molina, Steven M Frank, Daniel M Sciubba
STUDY DESIGN: Retrospective study. OBJECTIVE: To describe the association between storage duration of packed red blood cells (PRBCs) and perioperative adverse events in patients undergoing spine surgery at a tertiary care center. SUMMARY OF BACKGROUND DATA: Despite retrospective studies that have shown that longer PRBC storage duration worsens patient outcomes, randomized clinical trials have found no difference in outcomes. However, no studies have examined the impact of giving the oldest blood (28 days-old or more) on morbidity within spine surgery...
November 17, 2017: Spine
https://www.readbyqxmd.com/read/29189528/incidence-and-diagnostic-evaluation-of-postoperative-fever-in-pediatric-patients-with-neuromuscular-disorders
#20
Mohamed A A Yousef, Darius Dranginis, Scott Rosenfeld
BACKGROUND: Children with neuromuscular disorders have a significant chance of developing scoliosis and/or hip dislocation during childhood and adolescence and often undergo surgical reconstruction. Because of their high rate of medical comorbidities, these patients are at higher risk of postoperative complications and are therefore often comanaged, along with orthopaedics, by pediatric medicine and critical care teams. Fever during the postoperative stay is a frequent occurrence and often prompts extensive diagnostic workup which increases the cost and burden on the health system but have unclear effects on the care of the patient...
November 16, 2017: Journal of Pediatric Orthopedics
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