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Spinal instrumentation infections

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https://www.readbyqxmd.com/read/29303132/surgical-decompression-for-traumatic-spinal-cord-injury-in-a-tertiary-center
#1
O A Ojo, E O Poluyi, B S Owolabi, O O Kanu, M O Popoola
BACKGROUND: There are controversies regarding the importance and timing of spinal cord decompression following trauma. Documented evidence shows that early decompression in the setting of acute spinal cord injury (SCI) improves neurologic outcomes. Our objective was to evaluate the outcome of posttraumatic spinal cord decompression with or without spinal stabilization in our region. METHODOLOGY: We performed a cross-sectional study on adult patients who presented with acute spinal cord compression of traumatic etiology within a 2-year period...
November 2017: Nigerian Journal of Clinical Practice
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
#2
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/29205141/deep-spinal-infection-in-instrumented-spinal-surgery-diagnostic-factors-and-therapy
#3
M Dobran, A Marini, M Gladi, D Nasi, R Colasanti, R Benigni, Francesca Mancini, M Iacoangeli, M Scerrati
AIM: Postoperative surgical site infections (SSI) are complication of spinal surgery. These complications may lead to a poor outcome with neurological deficits, spinal deformity and chronic pain. The purpose of this study is to explore the statistical value of diagnostic parameters and the proper therapy. METHOD: We retrospectively reviewed 550 patients who underwent spinal instrumentation at our department from January 2011 to December 2015. The SSI was present in 16 patients out of 550 operated...
May 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29191104/does-prior-spine-surgery-or-instrumentation-affect-surgical-outcomes-following-3-column-osteotomy-for-correction-of-thoracolumbar-deformities
#4
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/29178308/effect-of-intra-wound-vancomycin-for-spinal-surgery-a-systematic-review-and-meta-analysis
#5
REVIEW
Lun-Li Xie, Jun Zhu, Mao-Sheng Yang, Chang-Yuan Yang, Shun-Hong Luo, Yu Xie, Dan Pu
Intra-site prophylactic vancomycin in spine surgery is an effective method of decreasing the incidence of postsurgical wound infection. However, there are differences in the prophylactic programs used for various spinal surgeries. Thus, this systematic review and meta-analysis aimed to evaluate the effectiveness of using intra-wound vancomycin during spinal surgery and to explore the effects of dose-dependence and the method of administration in a subgroup analysis. A total of 628 citations or studies were searched in PubMed, Ovid, Web of Science, and Google Scholar that were published before August 2016 with the terms "local vancomycin", "intra-wound vancomycin", "intraoperative vancomycin", "intra-site vancomycin", "topical vancomycin", "spine surgery", and "spinal surgery"...
November 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/29171793/preoperative-skin-antisepsis-with-chlorhexidine-gluconate-versus-povidone-iodine-a-prospective-analysis-of-6959-consecutive-spinal-surgery-patients
#6
George M Ghobrial, Michael Y Wang, Barth A Green, Howard B Levene, Glen Manzano, Steven Vanni, Robert M Starke, George Jimsheleishvili, Kenneth M Crandall, Marina Dididze, Allan D Levi
OBJECTIVE The aim of this study was to determine the efficacy of 2 common preoperative surgical skin antiseptic agents, ChloraPrep and Betadine, in the reduction of postoperative surgical site infection (SSI) in spinal surgery procedures. METHODS Two preoperative surgical skin antiseptic agents-ChloraPrep (2% chlorhexidine gluconate and 70% isopropyl alcohol) and Betadine (7.5% povidone-iodine solution)-were prospectively compared across 2 consecutive time periods for all consecutive adult neurosurgical spine patients...
November 24, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29153469/postoperative-urinary-retention-or-difficulties-to-empty-the-bladder-in-young-patients-undergoing-posterior-spinal-fusion-for-adolescent-idiopathic-scoliosis
#7
Heli Keskinen, Linda Helenius, Olli Pajulo, Ilkka J Helenius
BACKGROUND: Postoperative urinary retention has been reported to affect up to 27% of adults undergoing degenerative lumbar spine surgery and approximately one-third of children undergoing lower-extremity orthopedic surgery. No data exist on the incidence and risk factors of postoperative urinary tract retention/difficulties to empty the bladder in young patients undergoing instrumented posterior spinal fusion. We aimed to characterize incidence, risk factors and treatment of postoperative urinary retention (POUR) and difficulties to empty the bladder in young patients undergoing posterior spinal fusion (PSF) for idiopathic scoliosis...
October 13, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29129272/incidence-and-risk-factors-for-infection-in-spine-surgery-a-prospective-multicenter-study-of-1764-instrumented-spinal-procedures
#8
Wenfei Gu, Laiyong Tu, Zhiquan Liang, Zhenbin Wang, Kahaer Aikenmu, Ge Chu, Enfeng Zhang, Jiang Zhao
BACKGROUND: Surgical site infection (SSI) is a common complication in spinal surgery, imposing a high burden on patients and society. However, information about its characteristics and related risk factors is limited. We designed this prospective, multicenter study to address this issue. METHODS: From January 2015 through February 2016, a total of 1764 patients who had spinal trauma or degenerative spinal diseases were treated with instrumented surgeries and followed up for 1 year with complete data...
November 9, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/29114274/outcomes-of-minimally-invasive-surgery-compared-to-open-posterior-lumbar-instrumentation-and-fusion
#9
Low Yong Lee, Zamzuri Idris, Tan Boon Beng, Teo Yian Young, Wong Chung Chek, Jafri Malin Abdullah, Wong Sii Hieng
Introduction: Degenerative spine disease is increasingly common. There are many spinal fusion techniques used to treat degenerative spine disease. This study aims to compare the functional outcome of open versus minimally invasive surgery (MIS) technique in posterior lumbar instrumentation and fusion in degenerative spine disease and to evaluate the perioperative outcome and complications between MIS and open surgery. Materials and Methods: This is an observational cross-sectional study conducted on all degenerative spine disease patients who underwent both methods of posterior lumbar instrumentation and fusion from 2010 to 2014 by the Orthopedic and Neurosurgery Department, Sarawak General Hospital...
October 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29093786/perioperative-medical-complications-after-posterior-approach-spinal-instrumentation-surgery-for-osteoporotic-vertebral-collapse-a-comparative-study-in-patients-with-primary-osteoporosis-and-those-with-secondary-osteoporosis
#10
Naohisa Miyakoshi, Takashi Kobayashi, Tetsuya Suzuki, Kazuma Kikuchi, Yuji Kasukawa, Yoichi Shimada
Study Design: A retrospective comparative study. Purpose: To compare perioperative medical complications after posterior approach spinal instrumentation surgery for osteoporotic vertebral collapse (OVC) between patients with primary osteoporosis and those with secondary osteoporosis. Overview of Literature: With increased aging of society, the demand for instrumentation surgery for an osteoporotic spine has been increasing. However, no studies have compared the rates or severities of perioperative complications after spinal instrumentation surgery between patients with primary osteoporosis and those with secondary osteoporosis...
October 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/29092639/a-single-center-intervention-to-discontinue-postoperative-antibiotics-after-spinal-fusion
#11
Ariane Lewis, Jessica Lin, Herbert James, Anne Clara Krok, Nicole Zeoli, Janine Healy, Tyler Lewis, Donato Pacione
INTRODUCTION: Postoperative antibiotics (PA) are often administered to patients after instrumented spinal surgery until all drains are removed to prevent surgical site infections (SSI). This practice is discouraged by numerous medical society guidelines, so our institutional Neurosurgery Quality Improvement Committee decided to discontinue use of PA for this population. METHODS: We retrospectively reviewed data for patients who had instrumented spinal surgery at our institution for seven months before and after this policy change and compared the frequency of SSI and development of antibiotic related complications in patients who received PA to those who did not (non-PA)...
November 2, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29073499/management-of-major-vascular-injury-during-pedicle-screw-instrumentation-of-thoracolumbar-spine
#12
Aleem K Mirza, Mohammed Ali Alvi, Ryan M Naylor, Panagiotis Kerezoudis, William E Krauss, Michelle J Clarke, Daniel L Shepherd, Ahmad Nassr, Randall R DeMartino, Mohamad Bydon
OBJECTIVES: Vascular injury is a rare complication of spinal instrumentation. Presentation can vary from immediate hemorrhage to pseudoaneurysm formation. In the literature, surgical approach to repair has varied based on anatomy, acuity of diagnosis, infection, and available technology. In this manuscript, we aim to describe our institutional experience with vascular injuries in thoraco-lumbar spine surgery. PATIENTS AND METHODS: We report our institutional experience of three cases of vascular injury secondary to pedicle screw misplacement and their management, as well as a review of the literature...
October 16, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29066036/diagnosis-and-management-of-spinal-infections
#13
Hideki Nagashima, Shinji Tanishima, Atsushi Tanida
The number of spinal infections has been increasing due to aging populations and larger numbers of immunocompromised hosts and intravenous drug users. Magnetic resonance imaging is a useful tool for the early diagnosis of spinal infections, and can yield positive findings just 3-5 days after disease onset. Before antibiotic administration, cultures must be initiated from blood and from specimens collected from the locus of infection. Based on the pathogens identified by culture, appropriate antibiotics should be selected with careful consideration of antimicrobial susceptibility and spinal tissue penetration...
October 20, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/29049254/one-stage-posterior-approaches-for-treatment-of-thoracic-spinal-infection-transforaminal-and-costotransversectomy-compared-with-anterior-approach-with-posterior-instrumentation
#14
Fu-Cheng Kao, Tsung-Ting Tsai, Chi-Chien Niu, Po-Liang Lai, Lih-Huei Chen, Wen-Jer Chen
Treating thoracic infective spondylodiscitis with anterior surgical approaches carry a relatively high risk of perioperative and postoperative complications. Posterior approaches have been reported to result in lower complication rates than anterior procedures, but more evidence is needed to demonstrate the safety and efficacy of 1-stage posterior approaches for treating infectious thoracic spondylodiscitis.Preoperative and postoperative clinical data, of 18 patients who underwent 2 types of 1-stage posterior procedures, costotransversectomy and transforaminal thoracic interbody debridement and fusion and 7 patients who underwent anterior debridement and reconstruction with posterior instrumentation, were retrospectively assessed...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29033574/surgical-site-infections-following-instrumented-stabilization-of-the-spine
#15
Ulrike Dapunt, Caroline Bürkle, Frank Günther, Wojciech Pepke, Stefan Hemmer, Michael Akbar
BACKGROUND: Implant-associated infections are still a feared complication in the field of orthopedics. Bacteria attach to the implant surface and form so-called biofilm colonies that are often difficult to diagnose and treat. Since the majority of studies focus on prosthetic joint infections (PJIs) of the hip and knee, current treatment options (eg, antibiotic prophylaxis) of implant-associated infections have mostly been adapted according to these results. OBJECTIVE: The aim of this study was to evaluate patients with surgical site infections following instrumented stabilization of the spine with regard to detected bacteria species and the course of the disease...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29030268/topical-vancomycin-to-reduce-surgical-site-infections-in-neurosurgery-study-protocol-for-a-multi-center-randomized-controlled-trial
#16
Alexander J Jonokuchi, Jared Knopman, Ryan E Radwanski, Moises A Martinez, Blake Eaton Samuel Taylor, Michael Rothbaum, Sean Sullivan, Trae R Robison, Eric Lo, Brandon R Christophe, Eliza M Bruce, Sabrina Khan, Christopher P Kellner, Dimitri Sigounas, Brett Youngerman, Emilia Bagiella, Peter D Angevine, Franklin D Lowy, E Sander Connolly
Surgical-site infections (SSIs) account for 20% of all healthcare-associated infections, are the most common nosocomial infection among surgical patients, and are a focus of quality improvement initiatives. Despite implementation of many quality care measures (e.g. prophylactic antibiotics), SSIs remain a significant cause of morbidity, mortality, and economic burden, particularly in the field of neurosurgery. Topical vancomycin is increasingly utilized in instrumented spinal and cardiothoracic procedures, where it has been shown to reduce the risk of SSIs...
October 10, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28979855/single-stage-anterior-debridement-and-reconstruction-with-tantalum-mesh-cage-for-complicated-infectious-spondylitis
#17
Shih-Chieh Yang, Hung-Shu Chen, Yu-Hsien Kao, Yuan-Kun Tu
AIM: To evaluate the clinical and radiographic results of patients with complicated infectious spondylitis treated with single-stage anterior debridement and reconstruction using tantalum mesh cage (TaMC) followed by immediate instrumentation. METHODS: Single-stage radical debridement and subsequent reconstruction with TaMC instead of autograft or allograft were performed to treat 20 patients with spinal deformity or instability due to complicated infectious spondylitis...
September 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28973658/a-novel-4-rod-technique-offers-potential-to-reduce-rod-breakage-and-pseudarthrosis-in-pedicle-subtraction-osteotomies-for-adult-spinal-deformity-correction
#18
Sachin Gupta, Murat Sakir Eksi, Christopher P Ames, Vedat Deviren, Blythe Durbin-Johnson, Justin S Smith, Munish C Gupta
BACKGROUND: Pedicle subtraction osteotomy (PSO) can be used to treat rigid sagittal plane deformities. Nonunions and rod breakages are known complications of PSO. OBJECTIVE: To assess outcomes of 2 methods of posterior instrumentation for PSO, traditional 2 rods vs a novel 4-rod technique in which 2 additional rods span only the osteotomy level. METHODS: This study was a retrospective, radiographic review of consecutive PSOs performed at 2 centers...
July 7, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28970960/risk-factors-of-surgical-site-infections-in-instrumented-spine-surgery
#19
M Dobran, A Marini, D Nasi, M Gladi, V Liverotti, M Della Costanza, F Mancini, M Scerrati
BACKGROUND: The incidence of wound infections associated with instrumented spine surgery ranges from 2 to 20%. These complications may lead to poor outcomes. Knowing the risk factors associated with surgical site infections (SSI) after utilizing spinal implants is essential to avoid these complications, including hardware removal. METHODS: We reviewed retrospectively 550 patients who underwent spinal fusion surgery from 2011 to 2015; 16 developed SSI after spinal instrumentation...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28913559/risk-factors-for-implant-removal-after-spinal-surgical-site-infection
#20
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
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