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https://www.readbyqxmd.com/read/29303921/blood-loss-management-in-spine-surgery
#1
Jesse E Bible, Muhammad Mirza, Mark A Knaub
Substantial blood loss during spine surgery can result in increased patient morbidity and mortality. Proper preoperative planning and communication with the patient, anesthesia team, and operating room staff can lessen perioperative blood loss. Advances in intraoperative antifibrinolytic agents and modified anesthesia techniques have shown promising results in safely reducing blood loss. The surgeon's attention to intraoperative hemostasis and the concurrent use of local hemostatic agents also can lessen intraoperative bleeding...
January 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29303132/surgical-decompression-for-traumatic-spinal-cord-injury-in-a-tertiary-center
#2
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/29300251/do-preoperative-corticosteroid-injections-increase-the-risk-for-infections-or-wound-healing-problems-after-spine-surgery-a-swiss-prospective-multicenter-cohort-study
#3
Mazda Farshad, Jakob M Burgstaller, Ulrike Held, Johann Steurer, Cyrill Dennler
STUDY DESIGN: Prospective multi-center cohort study. OBJECTIVES: This study evaluates the risk for surgical site infections (SSI) or wound healing problems (WHP) in patients who underwent corticosteroid injection prior to lumbar decompression surgery. SUMMARY OF BACKGROUND DATA: Corticosteroid injections are often used for the treatment of the degenerated spine. However, their well-known immunosuppressive effects could increase the risk for local infections, particularly if a surgical intervention follows the injection rapidly...
January 3, 2018: Spine
https://www.readbyqxmd.com/read/29283957/early-tracheostomy-in-patients-with-traumatic-cervical-spinal-cord-injury-appears-safe-and-may-improve-outcomes
#4
Christopher Flanagan, Benjamin R Childs, Timothy A Moore, Heather A Vallier
STUDY DESIGN: Retrospective case series OBJECTIVE.: To characterize outcomes associated with tracheostomy timing following traumatic cervical spinal cord injury (CSCI). SUMMARY OF BACKGROUND DATA: The morbidity associated with cervical spine trauma is substantially increased in the setting of concomitant CSCI. Despite recent evidence, it remains uncertain if early tracheostomy following traumatic CSCI can improve outcomes. METHODS: From January 1, 2007, to December 31, 2015, retrospective chart review identified seventy (70) patients who presented to a single Level 1 trauma center with traumatic CSCI and received tracheostomy for management of respiratory compromise...
December 27, 2017: Spine
https://www.readbyqxmd.com/read/29280934/causes-and-timing-of-unplanned-90-day-readmissions-following-spine-surgery
#5
Jeffrey Hills, Ahilan Sivaganesan, Inamullah Khan, Silky Chotai, Benjamin Weisenthal, Thomas Freeman, Marjorie Butler, Joseph Wick, Joshua Daryoush, Anthony Asher, Clinton J Devin
STUDY DESIGN: Retrospective Cohort Study OBJECTIVE.: To evaluate the causes, timing, and factors associated with unplanned 90-day readmissions following elective spine surgery. SUMMARY OF BACKGROUND DATA: Unplanned readmissions after spine surgery are costly and an important determinant of the value of care. Several studies using database information have reported on rates and causes of readmission. However, these often lack the clinical detail and actionable data necessary to guide early post-discharge interventions...
December 26, 2017: Spine
https://www.readbyqxmd.com/read/29279742/prevalence-and-complications-of-postoperative-transfusion-for-cervical-fusion-procedures-in-spine-surgery-an-analysis-of-11-588-patients-from-the-american-college-of-surgeons-national-surgical-quality-improvement-program-database
#6
Ahmed Aoude, Sultan Aldebeyan, Maryse Fortin, Anas Nooh, Peter Jarzem, Jean A Ouellet, Michael H Weber
Study Design: Retrospective cohort study. Purpose: The purpose of this study was to assess the rate of blood transfusion after cervical fusion surgery, and its effect on complication rates. Overview of Literature: Cervical spine fusions have gained interest in the literature since these procedures are now ever more frequently being performed in an outpatient setting with few complications. Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was used to identify patients that underwent cervical fusion from 2010 to 2013...
December 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/29238639/the-use-of-vacuum-dressings-for-dead-space-management-in-deep-surgical-site-infections-allows-implant-and-bone-graft-retention
#7
James P Watt, Robert N Dunn
Study Design: Retrospective, descriptive study. Objectives: Managing early surgical site infection following elective lumbar spine surgery remains a challenge with controversy regarding retention of instrumentation and bone graft. Wound closure may also pose considerable challenges. We aim to report on our method of managing deep surgical site infections complicating elective spine surgery with surgeon assembled deep vacuum dressings. Identification of causative organisms with their sensitivities was a secondary objective...
December 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29238110/intrawound-vancomycin-powder-as-the-prophylaxis-of-surgical-site-infection-after-invasive-spine-surgery-with-a-high-risk-of-infection
#8
Tetsuro Hida, Kei Ando, Kazuyoshi Kobayashi, Kenyu Ito, Mikito Tsushima, Akiyuki Matsumoto, Masayoshi Morozumi, Satoshi Tanaka, Masaaki Machino, Kyotaro Ota, Shunsuke Kanbara, Sadayuki Ito, Yoshihiro Nishida, Naoki Ishiguro, Shiro Imagama
Surgical site infections (SSIs) are one of the most serious complications in spine surgery. We investigated the efficacy of locally administered vancomycin (VCM) powder for prophylaxis on SSI after invasive spine surgery. We retrospectively studied 174 consecutive patients who underwent spine surgery. In patients of the VCM group (n = 81), VCM powder was administered in the wound before closing wound. Patients who did not receive VCM treatment were set as a control group (n = 93). We compared the patients' background, operation time, intraoperative blood loss, usage of implants, presence of deep SSI, and side effects between the two groups...
November 2017: Nagoya Journal of Medical Science
https://www.readbyqxmd.com/read/29184720/risk-factors-for-wound-complications-following-spine-surgery
#9
Keaton F Piper, Samuel B Tomlinson, Gabrielle Santangelo, Joseph Van Galen, Ian DeAndrea-Lazarus, James Towner, Kristopher T Kimmell, Howard Silberstein, George Edward Vates
Background: Wound complications, including surgical site infections (SSIs) and wound dehiscence, are among the most common complications following spine surgery often leading to readmission. The authors sought to identify preoperative characteristics predictive of wound complications after spine surgery. Methods: The American College of Surgeons National Surgical Quality Improvement Program database for years 2012-2014 was reviewed for patients undergoing spine surgery, defined by the Current Procedural Terminology codes...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29171793/preoperative-skin-antisepsis-with-chlorhexidine-gluconate-versus-povidone-iodine-a-prospective-analysis-of-6959-consecutive-spinal-surgery-patients
#10
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/29129272/incidence-and-risk-factors-for-infection-in-spine-surgery-a-prospective-multicenter-study-of-1764-instrumented-spinal-procedures
#11
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/29098088/intraoperative-disinfection-by-pulse-irrigation-with-povidone-iodine-solution-in-spine-surgery
#12
Vincenzo De Luna, Federico Mancini, Fernando De Maio, Gabriele Bernardi, Ernesto Ippolito, Roberto Caterini
Background: Deep wound infection in spine surgery is a debilitating complication for patients and increases costs. The objective of this prospective study was to evaluate the efficacy of wound pulse irrigation with a dilute povidone-iodine solution in the prevention of surgical site infection. Methods: 50 patients undergoing spinal surgery were randomly divided into two groups (A and B) of 25 patients each. In group A, wounds were irrigated with dilute (3%) povidone-iodine solution through a low-pressure pulsatile device...
2017: Advances in Orthopedics
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
#13
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/29076762/surgical-site-infection-after-transoral-versus-posterior-approach-for-atlantoaxial-fusion-a-matched-cohort-study
#14
Mohamed Macki, Azam Basheer, Ian Lee, Ryan Kather, Ilan Rubinfeld, Muwaffak M Abdulhak
OBJECTIVE In the past, spine surgeons have avoided the transoral approach to the atlantoaxial segment because of concerns for unacceptable patient morbidity. The objective of this study was to measure 30-day postoperative complications, especially surgical site infection (SSI), after transoral versus posterior approach to atlantoaxial fusion. METHODS The source population was provided by the American College of Surgeons National Surgical Quality Improvement Program database, which was queried for all patients who underwent atlantoaxial fusion for degenerative/spondylotic disease and/or trauma between 2005 and 2014...
October 27, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29064871/best-practice-guidelines-for-surgical-site-infection-prevention-with-surgical-treatment-of-early-onset-scoliosis
#15
Michael P Glotzbecker, Tricia A St Hilaire, Jeff B Pawelek, George H Thompson, Michael G Vitale
BACKGROUND: Postoperative surgical site infection (SSI) is unfortunately a commonly encountered complication in the surgical treatment of children with Early Onset Scoliosis (EOS). There is documented variation in the treatment of this patient population. Previous work building consensus for the approach to high risk patients (eg, neuromuscular etiology) has been promising. The goal of the current study is to apply similar principles to develop consensus-based guidelines for the treatment of patients with EOS...
October 23, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29050716/postoperative-spine-dressing-changes-are-unnecessary
#16
Ravi S Bains, Mayur Kardile, Lance K Mitsunaga, Sukhraj Bains, Nirmal Singh, Cary Idler
INTRODUCTION: There is minimal literature regarding when dressing changes should be performed. We present the dressing change protocol adopted by our institution. The purpose of this study was to provide an update of our experience with this dressing change protocol over a 15-year period. METHODS: Effective January 2005, we implemented our universal protocol of no dressing changes for five days after surgery. Reviewing a health system administrative database, all spine surgery cases involving instrumentation performed at our institution were captured...
November 2017: Spine Deformity
https://www.readbyqxmd.com/read/29037974/impact-of-early-unanticipated-revision-surgery-on-health-related-quality-of-life-after-adult-spinal-deformity
#17
Susana Núñez-Pereira, Alba Vila-Casademunt, Montse Domingo-Sàbat, Juan Bagó, Emre R Acaroglu, Ahmet Alanay, Ibrahim Obeid, Francisco Javier Sánchez Pérez-Grueso, Frank Kleinstück, Ferran Pellisé
Background context Revision surgery represents a major event for patients undergoing ASD surgery. Previous reports suggest minimal or no impact on HRQOL outcomes. Purpose To investigate the impact of early reoperations within the first year on health-related quality of life (HRQOL) and on the likelihood of reaching the MCID after ASD surgery. Design Retrospective analysis of prospectively collected data from consecutive surgically treated adult deformity surgery (ADS) patients included in a multicenter, international database...
October 13, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29033574/surgical-site-infections-following-instrumented-stabilization-of-the-spine
#18
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/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/28965448/neuromuscular-scoliosis-complication-rates-from-2004-to-2015-a-report-from-the-scoliosis-research-society-morbidity-and-mortality-database
#20
Daniel Cognetti, Heather M Keeny, Amer F Samdani, Joshua M Pahys, Darrell S Hanson, Kathy Blanke, Steven W Hwang
OBJECTIVE Postoperative complications are one of the most significant concerns in surgeries of the spine, especially in higher-risk cases such as neuromuscular scoliosis. Neuromuscular scoliosis is a classification of multiple diseases affecting the neuromotor system or musculature of patients leading to severe degrees of spinal deformation, disability, and comorbidity, all likely contributing to higher rates of postoperative complications. The objective of this study was to evaluate deformity correction of patients with neuromuscular scoliosis over a 12-year period (2004-2015) by looking at changes in postsurgical complications and management...
October 2017: Neurosurgical Focus
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