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Spinal instrumentation infections

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https://www.readbyqxmd.com/read/29787876/risk-analysis-based-on-the-timing-of-tracheostomy-procedures-in-patients-with-spinal-cord-injury-requiring-cervical-spine-surgery
#1
Rita Galeiras, Mónica Mourelo, María Teresa Bouza, María Teresa Seoane, María Elena Ferreiro, Antonio Montoto, Sebastián Salvador, Leticia Seoane, David Freire
INTRODUCTION: To determine the optimal moment to carry out a tracheostomy in a patient requiring anterior cervical fixation. METHODS: A retrospective observational study was carried out over an 18-year period on 56 patients who had been admitted to the ICU with acute spinal cord injury (SCI), and who underwent a tracheostomy and surgical fixation. The sample was divided into two groups: An at-risk group (31 patients, who had undergone a tracheostomy prior to the cervical surgery or <4 days after the procedure), and a not at-risk group (25 patients, who had undergone a tracheostomy >4 day following the fixation surgery)...
May 19, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29771899/excess-cost-and-inpatient-stay-of-treating-deep-spinal-surgical-site-infections
#2
James Barnacle, Dianne Wilson, Christopher Little, Christopher Hoffman, Nigel Raymond
AIM: To determine the excess cost and hospitalisation associated with surgical site infections (SSI) following spinal operations in a New Zealand setting. METHODS: We identified inpatients treated for deep SSI following primary or revision spinal surgery at a regional tertiary spinal centre between 2009 and 2016. Excess cost and excess length of stay (LOS) were calculated via a clinical costing system using procedure-matched controls. RESULTS: Twenty-eight patients were identified...
May 18, 2018: New Zealand Medical Journal
https://www.readbyqxmd.com/read/29770586/surgical-infection-after-posterolateral-lumbar-spine-arthrodesis-ct-analysis-of-spinal-fusion
#3
Pablo Andrés-Cano, Ana Cerván, Miguel Rodríguez-Solera, Jose Antonio Ortega, Natividad Rebollo, Enrique Guerado
OBJECTIVE: To determine the incidence of infection after instrumented lumbar spine surgery, the demographic and surgical variables associated with acute infection, and the influence of infection and debridement on the consolidation of spinal fusion. METHODS: After obtaining approval from the hospital ethics committee, an observational study was made on a prospective cohort of consecutive patients surgically treated by posterolateral lumbar spine arthrodesis (n = 139, 2005-2011)...
May 16, 2018: Orthopaedic Surgery
https://www.readbyqxmd.com/read/29735145/growth-friendly-surgery-is-effective-at-treating-early-onset-scoliosis-associated-with-goldenhar-syndrome
#4
Braydon Connell, Jonathan J Oore, Joshua M Pahys, George H Thompson, Tricia St Hilaire, Tara Flynn, Ron El-Hawary
OBJECTIVE: To evaluate the radiographic results and complications of growth-friendly (GF) surgery in the treatment of early-onset scoliosis (EOS) associated with Goldenhar syndrome. BACKGROUND: Goldenhar syndrome has been associated with spinal deformity, which may be progressive. Efficacy and complication rate of GF treatment has not been reported for this population of patients with EOS. METHODS: Patients with Goldenhar syndrome and EOS with two years' follow-up were identified from two international multicenter EOS databases...
May 2018: Spine Deformity
https://www.readbyqxmd.com/read/29726801/reduction-in-surgical-site-infection-with-suprafascial-intrawound-application-of-vancomycin-powder-in-instrumented-posterior-spinal-fusion-a-retrospective-case-control-study
#5
Shoichi Haimoto, Ralph T Schär, Yusuke Nishimura, Masahito Hara, Toshihiko Wakabayashi, Howard J Ginsberg
OBJECTIVE Recent studies have demonstrated the efficacy of subfascial intrawound application of vancomycin powder in spine surgery in reducing the rate of surgical site infections (SSIs). However, to date no study has evaluated the efficacy and safety of suprafascial application of vancomycin powder in spine surgery. The purpose of this study was to quantify the rate of SSIs after open instrumented posterior spinal fusion with and without application of suprafascial vancomycin powder and to evaluate the rate of vancomycin powder-related local adverse effects...
May 4, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29719912/vascularized-bone-grafting-for-reconstruction-of-oncologic-defects-in-the-spine-a-systematic-review-and-pooled-analysis-of-the-literature
#6
Rachel Pedreira, Charalampos Siotos, Brian H Cho, Stella M Seal, Deepa Bhat, Hannah M Carl, Michelle Seu, J P Wolinksy, Justin M Sacks
BACKGROUND:  Resection of primary spinal tumors requires reconstruction for restoration of spinal column stability. Traditionally, some combination of bone grafting and instrumentation is implemented. However, delayed healing environments are associated with pseudoarthrodesis and failure. Implementation of vascularized bone grafting (VBG) to complement hardware may present a solution. We evaluated the use of VBG in oncologic spinal reconstruction via systematic review and pooled analysis of literature...
May 2, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29705336/does-intrawound-vancomycin-powder-reduce-surgical-site-infection-after-posterior-instrumented-spinal-surgery-a-propensity-score-matched-analysis
#7
Chiaki Horii, Takashi Yamazaki, Hiroyuki Oka, Seiichi Azuma, Satoshi Ogihara, Rentaro Okazaki, Naohiro Kawamura, Yuichi Takano, Jiro Morii, Yujiro Takeshita, Toru Maruyama, Kiyofumi Yamakawa, Motoaki Murakami, Yasushi Oshima, Sakae Tanaka
BACKGROUND CONTEXT: Recent reports suggested that placing vancomycin powder into surgical wounds before closure can prevent surgical site infections (SSIs) in spinal surgery. PURPOSE: To evaluate if intrawound vancomycin powder can prevent SSIs after spinal surgery with posterior instrumentation. STUDY DESIGN: A multi-center retrospective cohort study using propensity score matching. PATIENT SAMPLE: We reviewed all spinal surgeries performed with posterior instrumentation from July 2012 to December 2014 at 11 institutions among patients aged ≥15 years...
April 26, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29600426/antibiotic-induced-fever-in-orthopaedic-patients-a-diagnostic-challenge
#8
Kirsten Labbus, Jana Karina Junkmann, Carsten Perka, Andrej Trampuz, Nora Renz
INTRODUCTION: Antibiotic-induced fever is a probably underestimated complication, which may be misdiagnosed as new infection. In this study, characteristics, diagnostic approach, and outcome of antibiotic-induced fever in patients treated for musculoskeletal infections are described. METHODS: We retrospectively reviewed all patients with antibiotic-induced fever after surgery treated at our institution from 2014 to 2017. Antibiotic-induced fever was diagnosed, if the following criteria were fulfilled: (i) central (ear) body temperature > 38...
March 29, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29595747/postoperative-infection-in-patients-undergoing-posterior-lumbosacral-spinal-surgery-a-pictorial-guide-for-diagnosis-and-early-treatment
#9
Shih-Hao Chen, Wen-Jer Chen, Meng-Huang Wu, Jen-Chung Liao, Chen-Ju Fu
Surgical site infections after posterior spinal surgery may lead to spondylodiscitis, pseudarthrosis, correction loss, adverse neurological sequelae, sepsis, and poor outcomes if not treated immediately. Infection rates vary depending on the type and extent of operative procedures, use of instrumentation, and patients' risk factors. Image evaluation is crucial for early diagnosis and should be complementary to clinical routes, laboratory survey, and treatment timing. Magnetic resonance imaging detects early inflammatory infiltration into the vertebrae and soft tissues, including hyperemic changes of edematous marrow, vertebral endplate, and abscess or phlegmon accumulation around the intervertebral disk, epidural, and paravertebral spaces...
March 27, 2018: Clinical Spine Surgery
https://www.readbyqxmd.com/read/29593923/delayed-adjacent-level-spondylodiscitis-after-initial-surgery-with-instrumented-spinal-fusion-a-report-of-three-cases-and-review-of-the-literature
#10
Narihito Nagoshi, Masanobu Shioda, Etsuro Yorimitsu, Mitsuru Yagi
To date, 2 cases of adjacent level spondylodiscitis occurring a few months after initial spinal fusion were reported. However, the development of delayed adjacent level spondylodiscitis is very rare. The authors report 3 cases of spondylodiscitis that occurred at the proximal adjacent level of the fused spine more than 1 year after the initial surgery. Antibiotic treatment was initially chosen in all three cases. In two of the cases, progressive neurological deficit occurred at the level of the infection due to compression of neural elements and spinal instability...
2018: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/29576906/lower-complication-and-reoperation-rates-for-laminectomy-rather-than-mi-tlif-other-fusions-for-degenerative-lumbar-disease-spondylolisthesis-a-review
#11
REVIEW
Nancy E Epstein
Background: Utilizing the spine literature, we compared the complication and reoperation rates for laminectomy alone vs. instrumented fusions including minimally invasive (MI) transforaminal lumbar interbody fusion (TLIF) for the surgical management of multilevel degenerative lumbar disease with/without degenerative spondylolisthesis (DS). Methods: Epstein compared complication and reoperation rates over 2 years for 137 patients undergoing laminectomy alone undergoing 2-3 level (58 patients) and 4-6 level (79 patients) Procedures for lumbar stenosis with/without DS...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29572738/staged-insertion-of-growing-rods-in-severe-scoliosis
#12
Sebastiaan Schelfaut, Jennifer A Dermott, Reinhard Zeller
PURPOSE: The objective of this retrospective chart and radiographic review was to present the clinical outcomes and complication rate of a staged approach to modern dual growing-rod (GR) surgery when treating children with severe early onset scoliosis. METHODS: Fifteen patients received a 6-mm dual GR system. During Stage 1, pairs of end vertebra were exposed in a subperiosteal fashion, instrumented, grafted, and fused. Stage 2 was performed, on average, 5 months later (range 8-35 weeks) and the fused foundations were connected with two growing rods under skull-femoral traction...
March 23, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29557925/validation-of-patient-reported-outcomes-measurement-information-system-promis-computer-adaptive-tests-cats-in-the-surgical-treatment-of-lumbar-spinal-stenosis
#13
Alpesh A Patel, Shah-Nawaz M Dodwad, Barrett S Boody, Surabhi Bhatt, Jason W Savage, Wellington K Hsu, Nan E Rothrock
STUDY DESIGN: Prospective, cohort study. OBJECTIVE: Demonstrate validity of PROMIS physical function, pain interference, and pain behavior computer adaptive tests (CATs) in surgically treated lumbar stenosis patients. SUMMARY OF BACKGROUND DATA: There has been increasing attention given to patient reported outcomes associated with spinal interventions. Historical patient outcome measures have inadequate validation, demonstrate floor/ceiling effects, and infrequently used due to time constraints...
March 19, 2018: Spine
https://www.readbyqxmd.com/read/29556679/-infections-after-reconstructive-spinal-interventions-how-do-i-deal-with-them
#14
REVIEW
Burkhard Lehner, Michael Akbar, Nicholas A Beckmann
BASICS: Postoperative surgical site infections of the spine have been described in up to 20% of patients and can result in serious consequences for the patient and substantial treatment costs. Typical bacteria often arise from skin or fecal flora. Various risk factors for infection have been described, including obesity, diabetes, high ASA scores, as well as intraoperative factors such as heavy blood loss, dural tears, or several revision procedures. Consequently, the prophylaxis with pre- and postoperative risk minimization is of particular importance...
April 2018: Der Orthopäde
https://www.readbyqxmd.com/read/29547061/risk-factors-for-wound-related-reoperations-in-patients-with-metastatic-spine-tumor
#15
Hannah M Carl, A Karim Ahmed, Nancy Abu-Bonsrah, Rafael De la Garza Ramos, Eric W Sankey, Zachary Pennington, Ali Bydon, Timothy F Witham, Jean-Paul Wolinsky, Ziya L Gokaslan, Justin M Sacks, C Rory Goodwin, Daniel M Sciubba
OBJECTIVE Resection of metastatic spine tumors can improve patients' quality of life by addressing pain or neurological compromise. However, resections are often complicated by wound dehiscence, infection, instrumentation failures, and the need for reoperation. Moreover, when reoperations are needed, the most common indication is surgical site infection and wound breakdown. In turn, wound reoperations increase morbidity as well as the length and cost of hospitalization. The aim of this study was to examine perioperative risk factors associated with increased rate of wound reoperations after metastatic spine tumor resection...
March 16, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29545868/diagnosis-and-management-of-spinal-tuberculosis-combined-with-brucellosis-a-case-report-and-literature-review
#16
Dexin Zou, Junlin Zhou, Xiaobing Jiang
Tuberculosis combined with brucellosis is a very rare condition. Overlapping clinical presentation and laboratory parameters of tuberculosis and brucellosis may lead to misdiagnosis or delayed diagnosis of the condition. The current study presents the case of a 45-year-old male with symptoms of lower back pain, non-tender swelling in the right flank, intermittent hyperpyrexia, sweating, body aches and numbness and weakness of right lower limb. A lumbar computed tomograph (CT) scan and magnetic resonance imaging indicated vertebral destruction and the formation of sequestra and thecal sac compression...
April 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29537960/minimally-invasive-surgery-mis-approaches-to-thoracolumbar-trauma
#17
Ian David Kaye, Peter Passias
Minimally invasive surgical (MIS) techniques offer promising improvements in the management of thoracolumbar trauma. Recent advances in MIS techniques and instrumentation for degenerative conditions have heralded a growing interest in employing these techniques for thoracolumbar trauma. Specifically, surgeons have applied these techniques to help manage flexion- and extension-distraction injuries, neurologically intact burst fractures, and cases of damage control. Minimally invasive surgical techniques offer a means to decrease blood loss, shorten operative time, reduce infection risk, and shorten hospital stays...
March 2018: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29527396/how-to-perform-the-wiltse-posterolateral-spinal-approach-technical-note
#18
A Guiroy, A Sícoli, N Gonzalez Masanés, A Morales Ciancio, M Gagliardi, A Falavigna
Background: The paraspinal, posterolateral, or Wiltse approach is an old technique that observes the principles of an MIS procedure. The aim of this study was to provide a step-by-step description from the literature of the Wiltse paraspinal approach and analyze its main advantages and limitations. Methods: Here, we provide a step-by-step description of the Wiltse approach. Utilizing PubMed and Lilacs and the Mesh terms "Wiltse approach," "paraspinal approach," "muscle sparing approach," and "lumbar spine," we identified 10 papers...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29506769/risk-factors-for-surgical-site-infection-following-spinal-instrumentation-surgery
#19
Hirokazu Shoji, Toru Hirano, Kei Watanabe, Masayuki Ohashi, Tatsuki Mizouchi, Naoto Endo
BACKGROUND: In spinal instrumentation surgeries, surgical site infection (SSI) is one of the complications to be avoided. However, spinal instrumentation surgeries have a higher rate of SSI than other clean orthopedic surgeries. The purpose of this study was to investigate the risk factors for SSI following spinal instrumentation surgeries and contribute to the prevention of SSIs by identifying high-risk patients. METHODS: Records of 431 patients who underwent spinal instrumentation surgeries from 2011 to 2014 with a minimum follow-up period of 90 days were retrospectively reviewed...
May 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/29481377/management-of-early-deep-wound-infection-after-thoracolumbar-instrumentation-continuous-irrigation-suction-system-versus-vacuum-assisted-closure-system
#20
Wei Yuan, Xuan Liu, Xiaoshu Zhou, Lei Pei, Yue Zhu
STUDY DESIGN: A retrospective study. OBJECTIVE: To compare the clinical outcomes of continues irrigation suction systems (CISS) or vacuum assisted closure system (VACS) in early deep wound infection (DWI) after thoracolumbar instrumentation. SUMMARY OF BACKGROUND DATA: DWI after thoracolumbar instrumentation is challenging and debridement followed by either CISS or VACS has been proven to be effective. So far which one of the system has more advantages over the other remains unclear...
February 23, 2018: Spine
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