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Spinal instrumentation infections

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https://www.readbyqxmd.com/read/28540132/more-risks-and-complications-for-elective-spine-surgery-in-morbidly-obese-patients
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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...
March 31, 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
#11
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
#12
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
https://www.readbyqxmd.com/read/28291404/outcomes-and-effectiveness-of-posterior-occipitocervical-fusion-for-suboccipital-spinal-metastases
#13
Panya Luksanapruksa, Jacob M Buchowski, Neill M Wright, Frank H Valone, Colleen Peters, David B Bumpass
OBJECTIVE The incidence of suboccipital spinal metastases is rare but has increased given cancer patients' longer life expectancies. Operative treatment in this region is often challenging because of limited fixation points due to tumor lysis, as well as adjacent neural and vascular anatomy. Few studies have reported on this population of cancer patients. The purpose of this study was to evaluate clinical outcomes and complications of patients with suboccipital spinal metastases who had undergone posterior occipitocervical fixation...
May 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28291402/complication-rates-associated-with-3-column-osteotomy-in-82-adult-spinal-deformity-patients-retrospective-review-of-a-prospectively-collected-multicenter-consecutive-series-with-2-year-follow-up
#14
Justin S Smith, Christopher I Shaffrey, Eric Klineberg, Virginie Lafage, Frank Schwab, Renaud Lafage, Han Jo Kim, Richard Hostin, Gregory M Mundis, Munish Gupta, Barthelemy Liabaud, Justin K Scheer, Bassel G Diebo, Themistocles S Protopsaltis, Michael P Kelly, Vedat Deviren, Robert Hart, Doug Burton, Shay Bess, Christopher P Ames
OBJECTIVE Although 3-column osteotomy (3CO) can provide powerful alignment correction in adult spinal deformity (ASD), these procedures are complex and associated with high complication rates. The authors' objective was to assess complications associated with ASD surgery that included 3CO based on a prospectively collected multicenter database. METHODS This study is a retrospective review of a prospectively collected multicenter consecutive case registry. ASD patients treated with 3CO and eligible for 2-year follow-up were identified from a prospectively collected multicenter ASD database...
February 17, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28286279/management-of-esophageal-and-pharyngeal-perforation-as-complications-of-anterior-cervical-spine-surgery
#15
Moo Sung Kang, Kyung Hyun Kim, Jeong Yoon Park, Sung Uk Kuh, Dong Kyu Chin, Byung Ho Jin, Keun Su Kim, Yong Eun Cho
OBJECTIVE: To describe our experience in treating esophageal and pharyngeal perforation after anterior cervical spine surgery. METHODS: Six patients with esophageal injury and one patient with pharyngeal injury after anterior cervical spinal surgery, managed at our department between 2000 and 2015, were retrospectively analyzed. RESULTS: During the study period, seven patients (six male and one female; mean age, 45 years) presented with esophageal perforation...
March 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28267910/-surgical-management-of-spinal-deformity-in-a-patient-with-escobar-syndrome-review-of-the-literature
#16
M C Hernández-Hernández, J A Canales-Nájera, J S De La Cruz-Álvarez, M E Tena-Zanabria, J Matus-Jiménez
BACKGROUND: The non-lethal variant of the Escobar or multiple pterygium syndrome is an entity of autosomal recessive inheritance linked to the X chromosome; it is characterized by multiple pterygia (hence its name) located mainly in the neck (95%) and armpits (55%), as well as other orthopedic malformations such as a vertical talus, congenital hip dislocation, and congenital scoliosis. OBJECTIVE: To present an optional surgical technique for the management of severe spinal deformities...
July 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28259267/timing-of-complications-occurring-within-30-days-after-adult-spinal-deformity-surgery
#17
Rafael De la Garza Ramos, C Rory Goodwin, Peter G Passias, Brian J Neuman, Khaled M Kebaish, Virginie Lafage, Frank Schwab, Daniel M Sciubba
STUDY DESIGN: Cross-sectional study of a national surgical database. OBJECTIVE: To investigate the timing of complications after adult spinal deformity (ASD) surgery. SUMMARY OF BACKGROUND DATA: There is limited data on the range of days when complications after ASD surgery occur. METHODS: The American College of Surgeons National Surgical Quality Improvement database was reviewed for the years 2007-2013. Inclusion criteria were adult patients (over 21 years of age) who underwent spinal fusion for ASD...
March 2017: Spine Deformity
https://www.readbyqxmd.com/read/28255931/scary-gas-intravascular-intracranial-and-intraspinal-ectopic-gas-part-iii
#18
Claire K Sandstrom, Sherif F Osman, Ken F Linnau
While ectopic gas can be a sign of dangerous disease requiring immediate medical or surgical intervention, it can also be an incidental and benign finding. Intravenous gas and spinal vacuum gas are common and almost always benign. Intravascular gas is most often related to instrumentation and, if intraarticular, can cause end-organ ischemia; however, treatment is usually supportive. Pneumocephalus arises from a communication with paranasal sinuses or mastoids more often than from meningeal infection and can usually be managed nonoperatively...
March 2, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28218305/interaction-of-cutibacterium-%C3%A2-formerly-propionibacterium-acnes-with-bone-cells-a-step-toward-understanding-bone-and-joint-infection-development
#19
Guillaume Ghislain Aubin, Marc Baud'huin, Jean-Philippe Lavigne, Régis Brion, François Gouin, Didier Lepelletier, Cédric Jacqueline, Dominique Heymann, Karim Asehnoune, Stéphane Corvec
Cutibacterium acnes (formerly Propionibacterium acnes) is recognized as a pathogen in foreign-body infections (arthroplasty or spinal instrumentation). To date, the direct impact of C. acnes on bone cells has never been explored. The clade of 11 C. acnes clinical isolates was determined by MLST. Human osteoblasts and osteoclasts were infected by live C. acnes. The whole genome sequence of six isolates of this collection was analyzed. CC36 C. acnes strains were significantly less internalized by osteoblasts and osteoclasts than CC18 and CC28 C...
February 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28207621/mri-based-decision-making-of-implant-removal-in-deep-wound-infection-after-instrumented-lumbar-fusion
#20
Masahiro Kanayama, Tomoyuki Hashimoto, Keiichi Shigenobu, Fumihiro Oha, Akira Iwata, Masaru Tanaka
STUDY DESIGN: A retrospective study. OBJECTIVE: The aim of the study was to review the treatment of deep wound infection after posterior instrumented lumbar fusion, and thereby to optimize the decision-making process of implant removal or retention on the basis of magnetic resonance imaging (MRI) assessment. SUMMARY OF BACKGROUND DATA: Biofilm formed on the surface of the spinal implant prevents infiltration of antibiotics and makes the infection treatment more complicated...
March 2017: Clinical Spine Surgery
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