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Spinal instrumentation infections

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https://www.readbyqxmd.com/read/28913559/risk-factors-for-implant-removal-after-spinal-surgical-site-infection
#1
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/28894679/management-of-thoracic-disc-herniations-via-posterior-unilateral-modified-transfacet-pedicle-sparing-decompression-with-segmental-instrumentation-and-interbody-fusion
#2
Daniel A Carr, Andrey A Volkov, David L Rhoiney, Pradeep Setty, Ryan J Barrett, Roderick Claybrooks, Peter L Bono, Doris Tong, Teck M Soo
STUDY DESIGN: Retrospective consecutive case series. OBJECTIVE: The objective of this case series was to demonstrate the safety of a modified transfacet pedicle-sparing decompression and instrumented fusion in patients with thoracic disc herniations (TDHs). METHODS: Consecutive patients undergoing operative management of TDH from July 2007 to December 2011 using a posterior unilateral modified transfacet pedicle-sparing approach were identified...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28885343/risk-factors-and-the-surgery-affection-of-respiratory-complication-and-its-mortality-after-acute-traumatic-cervical-spinal-cord-injury
#3
Xiao-Xiong Yang, Zong-Qiang Huang, Zhong-Hai Li, Dong-Feng Ren, Jia-Guang Tang
The aim of this study is to estimate the risk factors of both respiratory complication (RC) and mortality after acute traumatic cervical spinal cord injury (TCSCI). Between July 2005 and July 2015, in 181 patients (142 males and 39 females; mean age 41.0 years) with acute TCSCI, we compared the difference and odds ratio in RC group (n = 73) with that of non-RC group (n = 108), and also death group (n = 15) and survival group (n = 166). We collected injury-related information after half a year of injury, which is as follows: the causes of injury, time of surgery, ICU (intensive care unit) days, ventilator days, ASIA (American Spinal Injury Association) classification, neurological injury, CIPS (Clinical Pulmonary Infection Score), and BMI (body mass index)...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28882354/surgical-treatment-with-pedicle-screws-of-scoliosis-associated-with-osteogenesis-imperfecta-in-children
#4
Lucas Piantoni, Mariano A Noel, Ida A Francheri Wilson, Carlos A Tello, Eduardo Galaretto, Rodrigo G Remondino, Ernesto S Bersusky
STUDY DESIGN: Retrospective study. OBJECTIVE: To assess results of posterior instrumented fusion using pedicle screws in 12 children with osteogenesis imperfecta (OI) with spinal deformity at a single institution from 2001 to 2012. SUMMARY OF BACKGROUND DATA: This is the first case series of OI patients who underwent non-cement augmented screw-rod instrumented fusion published in the literature. METHODS: Of a total of 54 children with spinal deformity associated with OI, 12 (22...
September 2017: Spine Deformity
https://www.readbyqxmd.com/read/28878518/on-demand-antibiotic-eluting-microchip-for-implanted-spinal-screws
#5
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/28870838/comparison-of-s2-alar-and-traditional-iliac-screw-pelvic-fixation-for-pediatric-neuromuscular-deformity
#6
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/28826928/the-relationship-between-cervical-lordosis-and-nurick-scores-in-patients-undergoing-circumferential-vs-posterior-alone-cervical-decompression-instrumentation-and-fusion-for-treatment-of-cervical-spondylotic-myelopathy
#7
Shalin Patel, Phillip Glivar, Farbod Asgarzadie, David Juma Wayne Cheng, Olumide Danisa
The loss of regional cervical sagittal alignment and the progressive development of cervical kyphosis is a factor in the advancement of myelopathy. Adequate decompression of the spinal canal along with reestablishment of cervical lordosis are desired objective with regard to the surgical treatment of patients with cervical spondylotic myelopathy. A retrospective chart review was conducted in which patients who underwent either a combined anterior/posterior instrumentation and decompression or a posterior alone instrumentation and decompression for the treatment of CSM at our institution were identified...
August 18, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28822825/comparison-of-transforaminal-lumbar-interbody-fusion-outcomes-in-patients-receiving-rhbmp-2-versus-autograft
#8
Taleef R Khan, Kalin R Pearce, Steven J McAnany, Colleen M Peters, Munish C Gupta, Lukas P Zebala
BACKGROUND CONTEXT: Recombinant human bone morphogenetic protein 2 (rhBMP-2) plays a pivotal role in complex spine surgery. Despite its limited approval, the off-label use of rhBMP-2 is prevalent, particularly in transforaminal lumbar interbody fusions (TLIF) PURPOSE: To determine the effectiveness and safety of rhBMP-2 use in TLIF procedures versus autograft. STUDY DESIGN: Retrospective Cohort Study PATIENT SAMPLE: Patients older than 18 years undergoing spine surgery for lumbar degenerative spine disease at a single academic institution...
August 16, 2017: Spine Journal: Official Journal of the North American Spine Society
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
#9
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
#10
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/28760654/surgical-outcome-of-thoracic-myelopathy-caused-by-ossification-of-ligamentum-flavum
#11
Hua Wang, Fuxin Wei, Houqing Long, Guowei Han, Shilabant Sen Sribastav, Zemin Li, Yangliang Huang, Ronglan Zhu, Chunxiang Liang
Ossification of the ligamentum flavum (OLF) may result in thoracic myelopathy (TM) because of the spinal canal narrowing. The aim of this study was to investigate clinical outcomes of symptomatic thoracic OLF treated using posterior decompressive laminectomy. We made a retrospective review of patients who underwent posterior decompressive laminectomy from 2007 through 2016 for symptomatic TM caused by OLF. Thirty-three patients who had surgery for TM caused by OLF that was diagnosed based on clinical, radiologic, and pathologic evaluations...
July 28, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28756380/a-case-of-deep-infection-after-instrumentation-in-dorsal-spinal-surgery-the-management-with-antibiotics-and-negative-wound-pressure-without-removal-of-fixation
#12
Mauro Dobran, Fabrizio Mancini, Davide Nasi, Massimo Scerrati
Until today the role of spinal instrumentation in the presence of a wound infection has been widely discussed and recently many authors leave the hardware in place with appropriate antibiotic therapy. This is a case of a 65-year-old woman suffering from degenerative scoliosis and osteoporotic multiple vertebral collapses treated with posterior dorsolumbar stabilisation with screws and rods. Four months later, skin necrosis and infection appeared in the cranial wound with exposure of the rods. A surgical procedure of debridement of the infected tissue and package with a myocutaneous trapezius muscle flap was performed...
July 28, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28730327/erratum-to-the-diagnosis-and-management-of-infection-following-instrumented-spinal-fusion
#13
Iona Collins, James Wilson-MacDonald, George Chami, Will Burgoyne, P Vinayakam, Tony Berendt, Jeremy Fairbank
No abstract text is available yet for this article.
July 20, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28705257/single-stage-transforaminal-decompression-debridement-interbody-fusion-and-posterior-instrumentation-for-lumbosacral-brucellosis
#14
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
#15
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/28688061/new-method-for-correction-of-lumbo-sacral-kyphosis-deformity-in-patient-with-high-pelvic-incidence
#16
Marcin Czyz, Stephen Forster, James Holton, Babak Shariati, David J Clarkson, Bronek M Boszczyk
STUDY DESIGN: Technical note. OBJECTIVE: We describe a novel technique of bilateral longitudinal sacral osteotomy allowing direct reduction of high pelvic incidence (PI) and correction of sagittal imbalance. METHODS: A 25-year-old female patient presented with a disabling lumbo-sacral kyphosis fused in situ through previous operations with residual low-grade wound infection and grade IV L5/S1 spondylolisthesis with severity index (SI) of 65%...
August 2017: European Spine Journal
https://www.readbyqxmd.com/read/28648472/oesophageal-pleural-fistula-presenting-with-parvimonas-micra-infection-causing-cervical-and-brain-abscesses
#17
REVIEW
Anan Shtaya, Helmut Schuster, Peter Riley, Kathryn Harris, Samantha Hettige
Parvimonas micra (P. micra) infections causing spinal cord compression are extremely rare. We report an occult oesophageal pleural fistula presenting with spinal epidural and brain abscesses resulting in severe neurological deficits caused by P. micra. Molecular detection proved to be instrumental in identifying the causative pathogen. Essential management with decompression, drainage, antibiotics and fistula repair lead to a good outcome.
June 23, 2017: Anaerobe
https://www.readbyqxmd.com/read/28631069/-s2-ala-iliac-screws-for-extended-pelvic-fixation-in-longer-lumbar-instrumentations-description-of-a-freehand-technique
#18
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
https://www.readbyqxmd.com/read/28630851/vacuum-assisted-closure-in-patients-with-post-operative-infections-after-instrumented-spine-surgery-a-series-of-12-cases
#19
Maya Kale, Pravin Padalkar, Varshil Mehta
INTRODUCTION: Post-operative wound infections after spinal surgery is a very serious problem, leading to a risk of significant morbidity which may even lead to prolonged hospitalization. Various treatment protocols have been recommended for debridement, antibiotic, and soft-tissue management, but with mixed results. However, the risk of morbidity is still high with these treatment options. Vacuum-assisted closure (VAC) system has been gaining popularity recently in the management of subacute, acute, and chronic wounds...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28627291/early-complications-morbidity-and-mortality-in-octogenarians-and-nonagenarians-undergoing-posterior-intra-operative-spinal-navigation-based-c1-2-fusion-for-type-ii-odontoid-process-fractures
#20
Basem Ishak, Till Schneider, Valerie Gimmy, Andreas W Unterberg, Karl L Kiening
Type II odontoid fractures represent the most common cervical spine injury in the elderly. The decision for surgical treatment is still controversial, particularly with regard to the elevated peri-operative risk attributed to frequent comorbidities and poor bone quality. The purpose of this study was to assess both short-term mortality and mid-term clinical and radiological outcome in the elderly. Between January 2007 and December 2015, 35 patients with type II odontoid process fractures who underwent posterior atlanto-axial instrumentation using a modified Goel-Harms technique were retrospectively analyzed and prospectively examined clinically and radiologically...
August 4, 2017: Journal of Neurotrauma
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