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spine surgical site infection

Jacob R Joseph, Brandon W Smith, Paul Park
OBJECTIVE: National databases are used with increasing frequency in spine surgery literature to evaluate patient outcomes. The differences between individual databases in relationship to outcomes of lumbar fusion are not known. We evaluated the variability in standard outcomes of posterior lumbar fusion between the University HealthSystem Consortium (UHC) database and the Healthcare Cost and Utilization Project National Inpatient Sample (NIS). METHODS: NIS and UHC databases were queried for all posterior lumbar fusions (ICD-9 81...
October 11, 2016: World Neurosurgery
Nicole K Behnke, Dustin K Baker, Shin Xu, Thomas E Niemeier, Shawna L Watson, Brent A Ponce
PURPOSE: The skeleton is the third most common site of cancer metastases. Approximately 10 % of patients with bone metastases will develop a pathologic fracture, with significant associated morbidity and mortality. The purpose of this study was to identify risk factors for same-admission mortality after pathologic fractures secondary to metastatic cancer. METHODS: The Nationwide Inpatient Sample database was queried from 2002 to 2013 for hospitalized patients with diagnoses of pathologic fracture and a primary cancer at high risk for skeletal metastasis...
October 4, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Stefan Hartveldt, Stein J Janssen, Kirkham B Wood, Thomas D Cha, Joseph H Schwab, Christopher M Bono, Louis G Jenis
STUDY DESIGN: Retrospective study. OBJECTIVE: To assess the relation between exposure to epidural steroid injection (ESI) before surgery and occurrence of surgical site infection (SSI) for degenerative lumbar spine conditions. SUMMARY OF BACKGROUND DATA: The effect of local ESI on the occurrence of SSI is controversial. METHODS: Patients who underwent surgery for degenerative lumbar spine conditions at two centers between 2005 and 2015 were identified...
October 1, 2016: Spine
Ross C Puffer, Meghan Murphy, Patrick Maloney, Daryl Kor, Ahmad Nassr, Brett Freedman, Jeremy Fogelson, Mohamad Bydon
STUDY DESIGN: A retrospective review of a consecutive series of spinal fusions comparing patient and procedural characteristics of patients who developed surgical site infections (SSIs) after spinal fusion. OBJECTIVE: It is known that increased surgical time (incision to closure) is associated with a higher rate of postoperative SSIs. We sought to determine whether increased total anesthetic time (intubation to extubation) is a factor in the development of SSIs as well...
September 28, 2016: Spine
Julien Billières, Ilker Uçkay, Antonio Faundez, Jonathan Douissard, Paulina Kuczma, Domizio Suvà, Mathieu Zingg, Pierre Hoffmeyer, Dennis E Dominguez, Guillaume Racloz
BACKGROUND: There is few medical literature regarding factors associated with remission after surgical and medical treatment of postoperative spine infections. METHODS: Single-centre case-control study 2007-2014. Cluster-controlled Cox regression model with emphasis on surgical and antibiotic-related parameters. RESULTS: Overall, we found 66 episodes in 48 patients (49 episodes with metalwork) who had a median follow-up of 2.6 years (range, 0...
June 2016: J Spine Surg
Aladine A Elsamadicy, Timothy Y Wang, Adam G Back, Amanda Sergesketter, Hunter Warwick, Isaac O Karikari, Oren N Gottfried
BACKGROUND: The effects and use of intra-operative steroids is relatively unknown and remains controversial. The aim of this is to determine if the effect of intra-operative steroid use on post-operative complications and length of hospital stay after spine surgery. METHODS: Medical records of 1200 adult patients undergoing spine surgery at Duke University Medical Center from 2008 to 2010 were retrospectively reviewed. There were 495 (41.25%) patients who were administered intra-operative steroids, and 705 (58...
September 22, 2016: World Neurosurgery
Robert F Murphy, James F Mooney
Complications following spine fusion for adolescent idiopathic scoliosis can be characterized as either intra-operative or post-operative. The most serious and feared complication is neurologic injury, both in the intra- and post-operative period. Other intra-operative complications include dural tears and ophthalmologic or peripheral nerve deficits, which may be related to positioning. Among the most common post-operative complications are surgical site infection, venous thromboembolism, gastrointestinal complications, and implant-related complications...
September 17, 2016: Current Reviews in Musculoskeletal Medicine
R A Atkinson, J Stephenson, A Jones, K J Ousey
OBJECTIVE: This study aimed to determine the rate of surgical site infection (SSI) in patients undergoing surgery for spinal metastases, and identify key risk factors for SSI among this patient group. METHOD: A retrospective case note review was undertaken in adult patients being treated at a single specialist centre for spinal surgery. RESULTS: There were 152 patients identified for inclusion. Overall SSI rate was 11.2 per 100 patients (9...
September 2016: Journal of Wound Care
Andrés Soto, Alberto Fica, Jeannette Dabanch, Felipe Olivares, Lorena Porte
BACKGROUND: Spondylodiscitis (SD) involves long periods of hospitalization, diagnostic latency and risk of long-term complications. No updated series are available in Chile and a change in demographic features and etiology is suspected. AIM: To characterize a group of patients with SD. PATIENTS AND METHODS: Clinical series including patients over an 8 year period. RESULTS: We identified 37 patients; 37.8% women and 62...
June 2016: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
John J Lee, Khalid I Odeh, Sven A Holcombe, Rakesh D Patel, Stewart C Wang, James A Goulet, Gregory P Graziano
Body mass index does not account for body mass distribution. This study tested the hypothesis that subcutaneous fat thickness is a better indicator than body mass index of the risk of surgical site infection in lumbar spine procedures performed through a midline posterior approach. Charts were reviewed for previously identified risk factors for surgical site infection (age, diabetes, smoking, obesity, albumin level, multilevel procedures, previous surgery, and operative time) in 149 adult patients who underwent lumbar spine procedures through a midline posterior approach...
August 30, 2016: Orthopedics
Ambar Haleem, Hsiu-Yin Chiang, Ravindhar Vodela, Andrew Behan, Jean M Pottinger, Joseph Smucker, Jeremy D Greenlee, Charles Clark, Loreen A Herwaldt
OBJECTIVE To identify risk factors for surgical site infections (SSIs) after spine operations. DESIGN Case-control study of SSIs among patients undergoing spine operations. SETTING An academic health center. PATIENTS We studied patients undergoing spinal fusions or laminectomies at the University of Iowa Hospitals and Clinics from January 1, 2007, through June 30, 2009. We included patients who acquired SSIs meeting the National Healthcare Safety Network definition. We randomly selected controls among patients who had spine operations during the study period and did not meet the SSI definition...
August 30, 2016: Infection Control and Hospital Epidemiology
Istvan Klemencsics, Aron Lazary, Zsolt Szoverfi, Arpad Bozsodi, Peter Eltes, Peter Pal Varga
BACKGROUND CONTEXT: Surgical site infection (SSI) is one of the most serious complications of spine surgery. Its predisposing factors, especially in routine surgeries, are less reported. However, a number of patient- and procedure-related risk factors could be avoided or at least determined preoperatively. Moreover, the patient-specific risk for SSI could be estimated before the elective surgery. PURPOSE: The aim of the present study was to analyze the preoperatively determinable risk factors for SSI in patients who require elective routine surgery related to lumbar disc degeneration and to build a multivariable model for the individual risk prediction...
August 9, 2016: Spine Journal: Official Journal of the North American Spine Society
Soichiro Masuda, Shunsuke Fujibayashi, Bungo Otsuki, Hiroaki Kimura, Masashi Neo, Shuichi Matsuda
BACKGROUND: Accidental dural tears are iatrogenic complications during spine surgery. However, there is no established intraoperative method or postoperative management in this situation. To examine the efficacy of the intraoperative method of dural repair, which consists of using the combination of a polyglycolic acid (PGA) mesh and fibrin glue, and the postoperative management of accidental dural tear or intended durotomy. METHODS: Seventy-five patients (34 males and 41 females; age range, 16-80 years; mean age, 57...
September 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Puraj P Patel, Jeremy A Warren, Roozbeh Mansour, William S Cobb, Alfredo M Carbonell
Lateral abdominal wall hernias may occur after a variety of procedures, including anterior spine exposure, urologic procedures, ostomy closures, or after trauma. Anatomically, these hernias are challenging and require a complete understanding of abdominal wall, interparietal and retroperitoneal, anatomy for successful repair. Mesh placement requires extensive dissection of often unfamiliar planes, and its fixation is difficult. We report our experience with open mesh repair of lateral abdominal wall hernias...
July 2016: American Surgeon
Shearwood McClelland, Richelle C Takemoto, Baron S Lonner, Tate M Andres, Justin J Park, Pedro A Ricart-Hoffiz, John A Bendo, Jeffrey A Goldstein, Jeffrey M Spivak, Thomas J Errico
INTRODUCTION: Wound infections following spinal surgery place a high toll on both the patient and the healthcare system. Although several large series studies have examined the incidence and distribution of spinal wound infection, the applicability of these studies varies greatly since nearly every study is either retrospective and/or lacks standard inclusion criteria for defining surgical site infection. To address this void, we present results from prospectively gathered thoracolumbar spine surgery data for which the Centers for Disease Control (CDC) criteria were stringently applied to define a surgical site infection (SSI)...
2016: International Journal of Spine Surgery
Joseph Featherall, Jacob A Miller, E Emily Bennett, Daniel Lubelski, Hannah Wang, Tagreed Khalaf, Ajit A Krishnaney
No abstract text is available yet for this article.
July 20, 2016: JAMA Surgery
Dong Wuk Son, Geun Sung Song
INTRODUCTION: The aims of our study were to evaluate the perioperative morbidities of patients who were taking antiplatelet medication in multilevel thoracolumbar spine surgery. METHODS: We retrospectively reviewed the medical records of 147 patients who underwent multilevel spine surgery from January 2009 to November 2014 at our institution. Cervical spine surgery and simple lumbar laminectomy operations were excluded. These patients were divided into 2 groups based on the preoperative antiplatelet medication...
August 2016: Neurosurgery
Aladine A Elsamadicy, Timothy Y Wang, Isaac O Karikari, Oren N Gottfried
INTRODUCTION: The effects and use of intraoperative steroids is relatively unknown and remains controversial. There have been conflicting studies demonstrating the efficacy of intraoperative steroids on postoperative dysphagia and inflammation, whereas others demonstrate no improvement in outcomes. The aim of this study is to determine if the use of intraoperative steroids affects postoperative complications and length of hospital stay after spine surgery. METHODS: The medical records of 1200 adult (=18 years old) patients undergoing spine surgery at Duke University Medical Center from 2008 to 2010 were retrospectively reviewed...
August 2016: Neurosurgery
Pavaman Pandit Sindgikar, Kuntal Kanti Das, Awadesh K Jaiswal, Rabi Narayan Sahu, Arun K Srivastava, Anant Mehrotra, Jayesh Chunilal Sardhara, Kamlesh Singh Bhaisora, Sanjay Behari
INTRODUCTION: Surgery for craniovertebral junction (CVJ) abnormalities like atlantoaxial dislocation (AAD) with or without basilar invagination (BI) and/or with or without associated Arnold-Chiari malformation (ACM) cause high cervical myelopathy. Occasionally, mechanical factors such as inadequate canal decompression, torticollis, and/or scoliosis may lead to lack of improvement following the primary surgery. Also, implant-related factors requiring its revision/removal or surgical site infections may cause patient to undergo resurgery...
August 2016: Neurosurgery
Silky Chotai, Ahilan Sivaganesan, Scott L Parker, Joseph Wick, David P Stonko, Matthew J McGirt, Clinton J Devin
INTRODUCTION: Current health care systems are rapidly transitioning from the "fee-for service" to the "pay-for performance" model. With this paradigm shift, the providers and payers are constantly striving to determine tools to provide cost-effective and high-quality patient care. Therefore, it is vital to account for the complications and their effects on the cost and quality of life. We set forth to determine the cost-utility associated with complications after lumbar spine surgery...
August 2016: Neurosurgery
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