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Spinal instrumentation infections

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https://www.readbyqxmd.com/read/28648472/oesophageal-pleural-fistula-presenting-with-parvimonas-micra-infection-causing-cervical-and-brain-abscesses
#1
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 22, 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
#2
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...
June 19, 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
#3
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-octo-and-nonagenarians-undergoing-posterior-intraoperative-spinal-navigation-based-c1-2-fusion-for-type-ii-odontoid-process-fractures
#4
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 perioperative risk attributed to frequent comorbidities and poor bone quality. 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...
June 18, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28606606/potential-risks-of-using-cement-augmented-screws-for-spinal-fusion-in-patients-with-low-bone-quality
#5
M Martín-Fernández, A López-Herrradón, A R Piñera, F Tomé-Bermejo, J M Duart, M D Vlad, M G Rodríguez-Arguisjuela, L Álvarez-Galovich
BACKGROUND CONTEXT: Dramatic increases in the average life expectancy have led to increases in the variety of degenerative changes and deformities observed in the aging spine. The elderly population can present challenges for spine surgeons, not only because of increased comorbidities, but also because of the quality of their bones. Pedicle screws are the implants used most commonly in spinal surgery for fixation, but their efficacy depends directly on bone quality. While PMMA-augmented screws represent an alternative for patients with osteoporotic vertebrae, their use has raised some concerns due to the possible association between cement leakages (CLs) and other morbidities...
June 9, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28591072/the-incremental-hospital-cost-and-length-of-stay-associated-with-treating-adverse-events-among-medicare-beneficiaries-undergoing-cervical-spinal-fusion-during-fiscal-year-2013-and-2014
#6
Steven D Culler, Kevin J McGuire, Kenneth M Little, David Jevsevar, Kevin Shea, Michael Schlosser, Karen E Ambrose, April W Simon
STUDY DESIGN: A retrospective study. OBJECTIVES: To report the incremental hospital resources consumed with treating adverse events experienced by Medicare beneficiaries undergoing a two or three vertebrae level cervical spinal fusion. SUMMARY OF BACKGROUND DATA: Hospitals are increasingly at financial risk for patients experiencing adverse events due "pay for performance". Little is known about incremental resources consumed when treating patients who experienced an adverse event following cervical spinal fusions...
June 6, 2017: Spine
https://www.readbyqxmd.com/read/28591055/stereoelectroencephalography-based-on-the-leksell-stereotactic-frame-and-neurotech-operation-planning-software
#7
Guangming Zhang, Guoqiang Chen, Dawei Meng, Yanwu Liu, Jianwei Chen, Lanmei Shu, Wenbo Liu
This study aimed to introduce a new stereoelectroencephalography (SEEG) system based on Leksell stereotactic frame (L-SEEG) as well as Neurotech operation planning software, and to investigate its safety, applicability, and reliability.L-SEEG, without the help of navigation, includes SEEG operation planning software (Neurotech), Leksell stereotactic frame, and corresponding surgical instruments. Neurotech operation planning software can be used to display three-dimensional images of the cortex and cortical vessels and to plan the intracranial electrode implantation...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28548996/distal-junctional-failure-following-pediatric-spinal-fusion
#8
Lorena V Floccari, Alvin W Su, Amy L McIntosh, Karl Rathjen, William J Shaughnessy, A Noelle Larson
BACKGROUND: Adjacent segment pathology is a known complication after spinal fusion, but little has been reported on junctional failure. A series of adolescent patients presented with acute distal junctional failure (DJF). We sought to determine any common features of these patients to develop a prevention strategy. METHODS: A retrospective review was conducted of pediatric patients who developed DJF after instrumented spinal fusion performed at 2 institutions from 1999 to 2013...
May 25, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28540132/more-risks-and-complications-for-elective-spine-surgery-in-morbidly-obese-patients
#9
REVIEW
Nancy E Epstein
BACKGROUND: The vast majority of studies emphasize the greater morbidity/mortality for elective spine surgery in morbidly obese patients. METHODS: This review focuses on the increased morbidity/mortality of performing elective spinal operations in morbidly obese patients. There are two definitions of morbid obesity; a body mass index (BMI) of equal to or greater than 35 plus two major comorbid factors (e.g., hypertension, diabetes, etc.) or a BMI (morbidly obese III) of =≥40 kg/m(2)...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28491215/clinical-outcomes-of-posterior-spinal-stabilization-with-rigid-vertical-strut-and-spinal-process-wires-the-adeolu-s-technique-in-a-developing-country
#10
Taopheeq Bamidele Rabiu
INTRODUCTION: Conventional instrumentation for spinal stabilization is beyond the reach of many patients in developing countries. A low-cost and easily-available method of spinal stabilization using vertical struts and spinal process wires (Adeolu's technique) was recently introduced in Nigeria. We describe the clinical outcomes of a prospective series of patients managed using the technique. METHODS: From 2011 to 2012, we performed posterior spinal stabilization in eighteen patients using the technique...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28463624/evaluation-of-robot-guided-minimally-invasive-implantation-of-2067-pedicle-screws
#11
Naureen Keric, Christian Doenitz, Amer Haj, Izabela Rachwal-Czyzewicz, Mirjam Renovanz, Dominik M A Wesp, Stephan Boor, Jens Conrad, Alexander Brawanski, Alf Giese, Sven R Kantelhardt
Objective Recent studies have investigated the role of spinal image guidance for pedicle screw placement. Many authors have observed an elevated placement accuracy and overall improvement of outcome measures. This study assessed a bi-institutional experience following introduction of the Renaissance miniature robot for spinal image guidance in Europe. Methods The medical records and radiographs of all patients who underwent robot-guided implantation of spinal instrumentation using the novel system (between October 2011 and March 2015 in Mainz and February 2014 and February 2016 in Regensburg) were reviewed to determine the efficacy and safety of the newly introduced robotic system...
May 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28463620/robotic-versus-fluoroscopy-guided-pedicle-screw-insertion-for-metastatic-spinal-disease-a-matched-cohort-comparison
#12
Volodymyr Solomiichuk, Julius Fleischhammer, Granit Molliqaj, Jwad Warda, Awad Alaid, Kajetan von Eckardstein, Karl Schaller, Enrico Tessitore, Veit Rohde, Bawarjan Schatlo
OBJECTIVE Robot-guided pedicle screw placement is an established technique for the placement of pedicle screws. However, most studies have focused on degenerative disease. In this paper, the authors focus on metastatic spinal disease, which is associated with osteolysis. The associated lack of dense bone may potentially affect the automatic recognition accuracy of radiography-based surgical assistance systems. The aim of the present study is to compare the accuracy of the SpineAssist robot system with conventional fluoroscopy-guided pedicle screw placement for thoracolumbar metastatic spinal disease...
May 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28441310/a-dose-response-curve-for-a-gram-negative-spinal-implant-infection-model-in-rabbits
#13
Joseph L Laratta, Jamal N Shillingford, Nathan Hardy, Ronald A Lehman, Lawrence G Lenke, K Daniel Riew
STUDY DESIGN: Randomized complete block animal spinal implant infection model with internal control. OBJECTIVE: To develop a spinal implant animal infection model to simulate postoperative gram-negative wound infection. SUMMARY OF BACKGROUND DATA: Implant-associated surgical site infections (SSI) remain a dreaded complication of spinal surgery. Currently, over 30% of all spine SSIs are secondary to gram-negative bacteria. Traditional animal models have utilized gram-positive inoculums to simulate postoperative infection, but there exists no model in the literature for gram-negative infection in the setting of spinal instrumentation...
April 24, 2017: Spine
https://www.readbyqxmd.com/read/28437330/pedicle-screw-fluid-sign-an-indication-on-magnetic-resonance-imaging-of-a-deep-infection-after-posterior-spinal-instrumentation
#14
Hiroaki Kimura, Jitsuhiko Shikata, Seiichi Odate, Tsunemitsu Soeda
STUDY DESIGN: A single-center case-referent study. OBJECTIVE: To assess whether the "pedicle screw (PS) fluid sign" on magnetic resonance imaging (MRI) can be used to diagnose deep surgical site infection (SSI) after posterior spinal instrumentation (PSI). SUMMARY OF BACKGROUND DATA: MRI is a useful tool for the early diagnosis of a deep SSI. However, the diagnosis is frequently difficult with feverish patients with clear wounds after PSI because of artifacts from the metallic implants...
May 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28435912/one-and-two-level-posterior-lumbar-interbody-fusion-plif-using-an-expandable-stand-alone-interbody-fusion-device-a-varilift-%C3%A2-case-series
#15
Rebecca Barrett-Tuck, Diana Del Monaco, Jon E Block
BACKGROUND: Surgical interventions such as posterior lumbar interbody fusion (PLIF) with and without posterior instrumentation are often employed in patients with degenerative spinal conditions that fail to respond to conservative medical management. The VariLift(®) Interbody Fusion System was developed as a stand-alone solution to provide the benefits of an intervertebral fusion device without the requirement of supplemental pedicle screw fixation. METHODS: In this retrospective case series, 25 patients underwent PLIF with a stand-alone VariLift(®) expandable interbody fusion device without adjunctive pedicle screw fixation...
March 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28414168/decompression-alone-versus-fusion-for-pyogenic-spondylodiscitis
#16
Sung Hyun Noh, Ho Yeol Zhang, Hyun Sun Lim, Hyeon Jin Song, Kyung Hwa Yang
BACKGROUND CONTEXT: A spinal infection is a serious problem for a spine surgeon, and there is currently much debate regarding how best to treat pyogenic spondylodiscitis using antibiotics and the instrumentations that have been developed to date. PURPOSE: The purpose of this study was to determine which is better method for treating pyogenic spondylodiscitis. STUDY DESIGN/SETTING: A retrospective chart review was performed. PATIENT SAMPLE: Thirty-one patients with pyogenic spondylodiscitis underwent surgical treatment between 2000 and 2016 at the authors' institution...
April 13, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28399551/risks-factors-for-reoperation-in-patients-treated-surgically-for-degenerative-spondylolisthesis-a-subanalysis-of-the-8-year-data-from-the-sport-trial
#17
Michael C Gerling, Dante Leven, Peter G Passias, Virgnie Lafage, Kristina Bianco, Alexandra Lee, Tamara S Morgan, Jon D Lurie, Tor D Tosteson, Wenyan Zhao, Kevin F Spratt, Kristen Radcliff, Thomas J Errico
STUDY DESIGN: Retrospective analysis of prospective data from the degenerative spondylolisthesis (DS) arm of the Spine Patient Outcomes Research Trial. OBJECTIVE: To identify risk factors for reoperation in patients treated surgically for DS and compare outcomes between patients who underwent reoperation with non-reoperative patients. SUMMARY OF BACKGROUND DATA: Several studies have examined outcomes following surgery for DS, but few have identified risk factors for reoperation...
April 10, 2017: Spine
https://www.readbyqxmd.com/read/28362214/a-systematic-multidisciplinary-initiative-for-reducing-the-risk-of-complications-in-adult-scoliosis-surgery
#18
Rajiv Sethi, Quinlan D Buchlak, Vijay Yanamadala, Melissa L Anderson, Eric A Baldwin, Robert S Mecklenburg, Jean-Christophe Leveque, Alicia M Edwards, Mary Shea, Lisa Ross, Karen J Wernli
OBJECTIVE Systematic multidisciplinary approaches to improving quality and safety in complex surgical care have shown promise. Complication rates from complex spine surgery range from 10% to 90% for all surgeries, and the overall mortality rate is 1%-4%. These rates suggest the need for improved perioperative complex spine surgery processes designed to minimize risk and improve quality. METHODS The Group Health Research Institute and Virginia Mason Medical Center implemented a systematic multidisciplinary protocol, the Seattle Spine Team Protocol, in 2010...
June 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28355144/the-effect-of-negative-pressure-wound-therapy-with-antiseptic-instillation-on-biofilm-formation-in-a-porcine-model-of-infected-spinal-instrumentation
#19
Devinder P Singh, Arvind U Gowda, Karan Chopra, Michael Tholen, Sarah Chang, Vasilios Mavrophilipos, Nina Semsarzadeh, Yvonne Rasko, Luther Holton Iii
OBJECTIVE: This study evaluates the effect of negative pressure wound therapy with antiseptic instillation (NPWTi) in the clearance of infection and biofilm formation in an in vivo model of infected spinal implants compared to traditional treatment modalities. MATERIALS AND METHODS: Five pigs underwent titanium rod implantation of their spinous processes followed by injection of 1 x 106 CFUs/100μL of methicillin-resistant Staphylococcus aureus through the fascia at each site...
March 24, 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28350952/future-advances-in-spine-surgery-the-aospine-north-america-perspective
#20
Michael G Fehlings, Christopher S Ahuja, Thomas Mroz, Wellington Hsu, James Harrop
This focus issue highlights state-of-the-art techniques, equipment, and practices in the modern era of spine surgery while providing a glimpse into the next generation of patient care. A broad range of topics are presented to cover the full spectrum of the field. Degenerative diseases are discussed in a series of 3 articles on (1) pathophysiology, management, and surgical approaches to degenerative cervical myelopathy; (2) novel approaches to degenerative thoracolumbar disease (eg, interspinous process spacers, minimally invasive/endoscopic approaches); and (3) animal models and emerging therapeutics in degenerative disk disease...
March 1, 2017: Neurosurgery
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