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Spinal instrumentation infections

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
Alexander J Jonokuchi, Jared Knopman, Ryan E Radwanski, Moises A Martinez, Blake Eaton Samuel Taylor, Michael Rothbaum, Sean Sullivan, Trae R Robison, Brandon R Christophe, 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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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...
November 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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