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Epidural Abscess

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https://www.readbyqxmd.com/read/28327980/frontal-sinus-breach-during-routine-frontal-craniotomy-significantly-increases-risk-of-surgical-site-infection-10-year-retrospective-analysis
#1
Joseph R Linzey, Thomas J Wilson, Stephen E Sullivan, B Gregory Thompson, Aditya S Pandey
BACKGROUND: Frontotemporal craniotomies are commonly performed for a variety of neurosurgical pathologies. Infections related to craniotomies cause significant morbidity. We hypothesized that the risk of cranial surgical site infections (SSIs) may be increased in patients whose frontal sinuses are breached during craniotomy. OBJECTIVE: To compare the rate of cranial SSIs in patients undergoing frontotemporal craniotomies with and without frontal sinus breach (FSB)...
March 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28324216/new-classification-for-the-treatment-of-pyogenic-spondylodiscitis-validation-study-on-a-population-of-250-patients-with-a-follow-up-of-2%C3%A2-years
#2
Enrico Pola, G Autore, V M Formica, V Pambianco, D Colangelo, R Cauda, M Fantoni
PURPOSE: Pyogenic spondylodiscitis (PS) is still burdened by a high rate of orthopedic and neurological complications. Despite the rising incidence, the choice of a proper orthopedic treatment is often delayed by the lack of clinical data. The aim of this study was to propose a clinical-radiological classification of pyogenic spondylodiscitis to define a standard treatment algorithm. METHODS: Based on data from 250 patients treated from 2008 to 2015, a clinical-radiological classification of pyogenic spondylodiscitis was developed...
March 21, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28319551/a-contemporary-medicolegal-analysis-of-implanted-devices-for-chronic-pain-management
#3
Christopher R Abrecht, Penny Greenberg, Ellen Song, Richard D Urman, James P Rathmell
BACKGROUND: Analysis of closed malpractice claims allows the study of rare but serious complications and likely results in improved patient safety by raising awareness of such complications. Clinical studies and closed claims analyses have previously reported on the common complications associated with intrathecal drug delivery systems (IDDS) and spinal cord stimulators (SCS). This study provides a contemporary analysis of claims from within the past 10 years. METHODS: We performed a closed claims analysis for a period January 1, 2009 to December 31, 2013 for cases with pain medicine as the primary service...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28284111/characteristics-and-predictors-of-outcome-of-spontaneous-spinal-epidural-abscesses-treated-conservatively-a-retrospective-cohort-study-in-a-referral-center
#4
Nikolaos Spernovasilis, Stelios Demetriou, Maria Bachlitzanaki, Ioannis Gialamas, Kalliopi Alpantaki, Georgios Hamilos, Apostolos Karantanas, Achilleas Gikas
OBJECTIVE: Recent studies have shown that in carefully selected patients, conservative treatment alone can be an option in the management of spinal epidural abscess (SEA). The aim of this study was to identify prognostic factors of outcome in patients with spontaneous SEA treated conservatively. PATIENTS AND METHODS: A retrospective cohort study of all patients with spontaneous SEA treated with antibiotics alone from January 2012 to December 2015 was conducted in a 1200-bed tertiary referral center...
February 27, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28260769/morbidity-and-mortality-after-pancreatoduodenectomy-a-five-year-experience-in-bangabandhu-sheikh-mujib-medical-university
#5
B C Das, A S Khan, N E Elahi, M S Uddin, B C Debnath, Z R Khan
Mortality and morbidity was assessed after adoption of a systematic care for patient with pancreatoduodenectomy starting from patient selection and preparation, operative technique, and postoperative care. In this prospective study seventy patients who underwent pancreatoduodenectomy for periampullary carcinoma with curative intent between January 2010 and December 2014 were carefully analyzed prospectively. Patients were selected those who had ampullary carcinoma, lower bile duct carcinoma and small size carcinoma head of pancreas without local invasion and distant metastasis, and the patient who did not have any major disabling comorbid diseases...
January 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28253945/-pyogenic-spinal-infections-in-adults-a-5-year-experience-from-a-tertiary-care-centre
#6
O Džupová, R Cihlářová
PURPOSE OF THE STUDY To describe epidemiological and clinical features of pyogenic spinal infections in patients treated at the Department of Infectious, Parasitic and Tropical Diseases of the Hospital Na Bulovce in 2010-2014, and to analyse a predictive significance of selected variables. MATERIAL AND METHODS A single-centre retrospective cohort study carried out from 1.1.2010 to 31.12.2014 enrolled adult patients with septic spondylitis, discitis and facet joint infections. Recorded parameters included: demographics, chronic comorbidities, time to diagnosis, radiological work-up, anatomical level of spinal infection, source of infection, etiological agent, complications, treatment and outcomes...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28250635/the-role-of-minimally-invasive-spine-surgery-in-the-management-of-pyogenic-spinal-discitis
#7
Mazda K Turel, Mena Kerolus, Harel Deutsch
BACKGROUND: Diagnostic yields for spondylodiscitis from CT guided biopsy is low. In the recent years, minimally invasive surgery (MIS) has shown to have a low morbidity and faster recovery. For spinal infections, MIS surgery may offer an opportunity for early pain control while obtaining a higher diagnostic yield than CT-guided biopsies. The aim of this study was to review our patients who underwent MIS surgery for spinal infection and report outcomes. METHODS: A retrospective review of seven patients who underwent MIS decompression and/or discectomy in the setting of discitis, osteomyelitis, spondylodiscitis, and/or an epidural abscess was identified...
January 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/28249310/diagnostic-yield-of-multidetector-computed-tomography-in-patients-with-acute-spondylodiscitis
#8
Vanessa Hanna Rausch, Peter Bannas, Gerhard Schoen, Andreas Froelich, Lennart Well, Marc Regier, Gerhard Adam, Frank Oliver Gerhard Henes
Purpose To determine the value of multidetector computed tomography (MDCT) in patients with acute spondylodiscitis. Methods and Materials For data acquisition, we searched our radiological database for all patients who had undergone magnetic resonance imaging (MRI) for suspected spondylodiscitis between 2007 and 2015 (n = 325). For further analyses, we included all patients (n = 67) who initially underwent MDCT prior to MRI. Overall accuracy, sensitivity, specificity and positive and negative predictive values were calculated for MDCT and, separately, for contrast-enhanced CT (CECT, n = 36) and for non-enhanced CT (NECT, n = 31)...
April 2017: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/28243340/magnetic-resonance-imaging-in-differentatial-diagnosis-of-pyogenic-spondylodiscitis-and-tuberculous-spondylodiscitis
#9
Małgorzata Frel, Jerzy Białecki, Janusz Wieczorek, Łukasz Paluch, Agnieszka Dąbrowska-Thing, Jerzy Walecki
BACKGROUND: Infectious spondylodiscitis is characterized by the involvement of two adjacent vertebrae and the intervening disc. Incidence rate of the disease is estimated at 0.4-2 cases per 100000 per year. Staphylococcus aureus is the most common infectious agent causing pyogenic spondylodiscitis. Non-pyogenic infections of the spine are most frequently caused by Mycobacterium tuberculosis, and fungi. Clinical symptoms are nonspecific. Early diagnosis and appropriate treatment can prevent unfavorable irreversible sequela for the patient...
2017: Polish Journal of Radiology
https://www.readbyqxmd.com/read/28239759/primary-acquired-spondylodiscitis-shows-a-more-severe-course-than-spondylodiscitis-following-spine-surgery-a-single-center-retrospective-study-of-159-cases
#10
Anja Tschugg, Sara Lener, Sebastian Hartmann, Andreas Rietzler, Sabrina Neururer, Claudius Thomé
Spondylodiscitis may arise primarily via hematogenous spread or direct inoculation of virulent organisms during spine surgery. To date, no comparative data investigating the differences between primary and postoperative spondylodiscitis is available. Thus, the purpose of this retrospective study was to investigate differences between these two etiologies. One hundred fifty-nine patients that were treated at our department were included in the retrospective analysis. The patients were categorized into two groups based on the etiology of spondylodiscitis: group NS, primary spondylodiscitis without prior spinal surgery; group S, spondylodiscitis following spinal surgery...
February 27, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28225879/high-cervical-spine-spondylodiscitis-management-and-literature-review
#11
André Luis Sebben, Xavier Soler Graells, Marcel Luiz Benato, Pedro Grein Del Santoro, Álynson Larocca Kulcheski
Spondylodiscitis affecting the cervical spine is the most unusual type. Disease progression can be dramatic, even causing quadriplegia and death. We present an unusual case that progressed with osteolytic lesions between C2 and C3, causing cord compression and epidural abscess. The patient was treated surgically by a double approach and improved without neurological deficits and with better inflammatory markers. We reviewed the current literature on the subject.
January 1, 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28187806/diagnosis-and-management-of-spinal-cord-emergencies
#12
REVIEW
E P Flanagan, S J Pittock
Most spinal cord injury is seen with trauma. Nontraumatic spinal cord emergencies are discussed in this chapter. These myelopathies are rare but potentially devastating neurologic disorders. In some situations prior comorbidity (e.g., advanced cancer) provides a clue, but in others (e.g., autoimmune myelopathies) it may come with little warning. Neurologic examination helps distinguish spinal cord emergencies from peripheral nervous system emergencies (e.g., Guillain-Barré), although some features overlap...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28163938/evaluating-complications-of-chronic-sinusitis
#13
Phillip Hong, Charles A Pereyra, Uta Guo, Adam Breslin, Laura Melville
Chronic sinusitis is a relatively common diagnosis throughout the US. In patients with an otherwise unremarkable medical history the treatment is typically supportive, requiring only clinical evaluation. We present the case of a 25-year-old male with a history of chronic sinusitis that was brought to our emergency department with new-onset seizure. Three days before he had presented to his usual care facility with two days of headache and fever and was discharged stating headache, subjective fever, and neck stiffness...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28159488/lateral-lumbar-retroperitoneal-transpsoas-approach-in-the-setting-of-spondylodiscitis-a-technical-note
#14
George M Ghobrial, Fadi Al-Saiegh, Daniel Franco, Daniel Benito, Joshua Heller
Thoracolumbar spondylodiscitis is a morbid disease entity, impacting a sick patient population with multiple comorbidities. Wherever possible, surgical measures in this population should limit the extent of soft tissue disruption and overall morbidity that is often associated with anteroposterior thoracolumbar decompression and fusion. The authors describe the rationale, technique, and use of the lateral lumbar transpsoas retroperitoneal approach in tandem with posterior decompression and instrumented fusion in the treatment of circumferential thoracolumbar spondylodiscitis with or without epidural abscesses...
January 31, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28134749/prognostic-factors-for-failure-of-antibiotic-treatment-in-patients-with-osteomyelitis-of-the-spine
#15
Jan Jaap de Graeff, Nuno Rui Paulino Pereira, Olivier D van Wulfften Palthe, Sandra B Nelson, Joseph H Schwab
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: Identify factors independently associated with antibiotic treatment failure in patients with spinal osteomyelitis. SUMMARY OF BACKGROUND DATA: There are few studies that have identified risk factors for antibiotic treatment failure in medically-managed spinal osteomyelitis. Identifying such factors could help to identify patients who can be treated solely with antibiotics. METHODS: All patients who underwent antibiotic treatment for spinal osteomyelitis in one of our institutions between January 1 2001 until January 1 2015 were identified...
January 27, 2017: Spine
https://www.readbyqxmd.com/read/28127138/primary-spinal-epidural-b-lymphoblastic-lymphoma
#16
Rakul K Nambiar, Sreejith G Nair, Pranab K Prabhakaran, Sherin P Mathew
Extranodal lymphomas constitute 20% to 30% of all non-Hodgkin's lymphomas. The common sites involved are skin, stomach, brain, and small intestine. Epidural localization is a rare site for lymphomas, accounting for 10% of spinal epidural tumors. Lymphomas occurring primarily in the epidural space without other previously detected lymphomatous foci (i.e., primary spinal epidural lymphomas) represent an even rarer entity. We report a case of primary spinal epidural B-lymphoblastic lymphoma. The patient presented with paraparesis, and a spinal epidural lesion was diagnosed...
January 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28115866/serratus-anterior-plane-block-for-hybrid-transthoracic-esophagectomy-a-pilot-study
#17
Cinzia Barbera, Pamela Milito, Michele Punturieri, Emanuele Asti, Luigi Bonavina
BACKGROUND: Pain is a major limiting factor in patient's recovery from major thoracic surgical procedures. Thoracic epidural analgesia (TEA), the current gold standard of perioperative management, has contraindications, can technically fail, and carries a risk of complications such as epidural abscess and spinal hematoma. The ultrasound-guided serratus anterior plane (SAP) block is a promising regional analgesia technique. OBJECTIVES: Since the anatomic space involved in the SAP block corresponds to the area exposed by the surgeon during right posterolateral thoracotomy, we investigated the feasibility of a "surgically guided" continuous SAP block as an alternative to TEA in selected esophagectomy patients...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28078834/magnetic-resonance-imaging-findings-of-patients-with-suspected-tuberculosis-from-a-tertiary-care-centre-in-sri-lanka
#18
A S Pallewatte, N A Wickramasinghe
Introduction: Spinal tuberculosis (TB) is a relatively common cause for spinal pathology in Sri Lanka and a common indication for magnetic resonance imaging (MRI). Objectives: The objective of the study was to describe the MRI imaging pattern of spinal TB in a series of patients. Methods: One hundred and nine patients with clinically confirmed spinal tuberculosis who had undergone MRI scans at the National Hospital of Sri Lanka from 2012-2016 were included in the study...
December 30, 2016: Ceylon Medical Journal
https://www.readbyqxmd.com/read/28068970/quadriplegia-caused-by-an-epidural-abscess-occurring-at-the-same-level-of-cervical-destructive-spondyloarthropathy-a-case-report
#19
Jun-Seok Lee, Ji-Hyun Ryu, Jong-Tae Park, Ki-Won Kim
BACKGROUND: Destructive spondyloarthropathy (DSA) is one of the major complications in patients undergoing long-term hemodialysis. To the best of our knowledge, an epidural abscess occurring at the level of preexisting cervical DSA has not been well described in the literature. We report a unique case of quadriplegia caused by an epidural abscess occurring at the same level of preexisting cervical DSA. CASE PRESENTATION: A 49-year-old woman was transferred to our emergency department with 5 days of sepsis, drowsy mental status, and quadriplegia below the C5 level...
January 10, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28068278/cervical-spondylitis-and-epidural-abscess-caused-by-brucellosis-a-case-report-and-literature-review
#20
Hatice Reşorlu, Suzan Saçar, Beşir Şahin Inceer, Ayla Akbal, Ferhat Gökmen, Coskun Zateri, Yilmaz Savaş
Brucellosis is a zoonotic disease widely seen in endemic regions and that can lead to systemic involvement. The musculoskeletal system is frequently affected, and the disease can exhibit clinical involvements such as arthritis, spondylitis, spondylodiscitis, osteomyelitis, tenosynovitis and bursitis. Spondylitis and spondylodiscitis, common complications of brucellosis, predominantly affect the lumbar and thoracic vertebrae. Epidural abscess may occur as a rare complication of spondylitis. Spinal brucellosis and development of epidural abscess in the cervical region are rare...
December 1, 2016: Folia Medica
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