in a single institution. Exclusion criteria were as follows : preceding the spine surgery in the previous 2 weeks, preexisting or postoperative infection, being less than 18 years of age, and being discharged less than 5 days after the spinal surgery. Clinical data relevant to the study included age, sex, body mass index (BMI), BT, site and type of surgery, and surgery duration.All patients received a preoperative antibiotic prophylaxis with a first generation cephalosporin, cefazolin, and also postoperative antibiotics were injected through their fourth postoperative day. All patients were operated under general anesthesia and received daily clinical examinations until discharge. INTRODUCTIONDespite advances in prophylaxis, the incidence of deep infection after instrumented spinal surgery remains between 0.4% and 4.3% 14,16,19) and may be higher in patients undergoing fusion after spinal trauma 26) . Although infection can be a disabling complication of any surgical procedure, spinal infection can be particularly devastating due to the close proximity of the neurological structures. Early detection of an infection may prevent substantial problem later.It is often difficult to diagnose postoperative spinal infection before clinical symptoms become apparent. Magnetic resonance imaging can help to diagnose the soft-tissue change but is expensive to use as a screening tool and may not be available. Although inflammatory markers, such as C-reactive protein (CRP), white blood cell count (WBC), erythrocyte sedimentation rate (ESR) and body temperature (BT), easily are measured, their specificities are not high.In a recent meta-analysis, procalcitonin (PCT) was superior to Objective : Classical markers of infection cannot differentiate reliably between inflammation and infection after neurosurgery. This study investigated the dynamics of serum procalcitonin (PCT) in patients who had elective spine surgeries without complications. Methods : Participants were 103 patients (47 women, 56 men) who underwent elective spinal surgery. Clinical variables relevant to the study included age, sex, medical history, body mass index (BMI), site and type of surgery, and surgery duration. Clinical and laboratory data were body temperature, white blood cell count (WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and PCT, all measured preoperatively and postoperatively on days 1, 3, and 5. Results : PCT concentrations remained at <0.25 ng/mL during the postoperative course except in 2 patients. PCT concentrations did not correlate with age, sex, DM, hypertension, BMI, operation time, operation site, or use of instrumentation. In contrast, CRP concentrations were significantly higher with older age, male, DM, hypertension, longer operation time, cervical operation, and use of instrumentation. Conclusion : PCT may be useful in the diagnosing neurosurgical patients with postoperative fever of unknown origin.
A novel peptide, P2K, regulating TGF-β1 signaling had an anabolic effect on bovine IVD cells and rabbit degenerated discs. The results suggest that P2K has considerable potential as a treatment of degenerative disc disease.
A 59-year-old man, who had a ventriculoperitoneal shunt (VPS) operation for the treatment of hydrocephalus due to cysticercosis 26 years prior, visited our hospital with increasing abdominal distention. An abdominal computed tomography (CT) scan showed well enhanced demarcated fluid collection about 20×18 cm around the distal catheter tip. We performed exploratory laparoscopy and inserted a drainage catheter into the abdominal cyst. All cyst fluid analyses and cultures were negative. Over the course of the next eight weeks, abdominal CT demonstrated that the pseudocyst decreased. Following removal of the drainage catheter, abdominal CT showed that the pseudocyst increased again. A drainage catheter was re-inserted and Taurolin ® (Taurolidine) solution irrigation was performed for 3 months. Upon the completion of this 3 months, the patient complained of abdominal distension and abdominal CT found both that the pseudocyst was increased and doubted cystic infection. Eventually, an exploratory laparotomy and cyst resection were performed. Although the occurrence of pseudocyst following VPS surgery is a rare complication, it can cause additional complications such as obstruction and infection. If a patient has gastrointestinal symptoms, pseudocyst should be considered as one of the complications of VPS surgery.
For securing large, giant, and wide-neck aneurysms, conventional coil embolization has substantial limitations, such as incomplete occlusion, recanalization, and a high recurrence rate. To overcome these limitations, a novel paradigm was suggested and, as a result, flow-diverting device was developed. The flow-diverting device is an innovative and effective technique to allow securing of large, giant, and wide-neck aneurysms. In numerous studies, the flow-diverting device has shown better outcomes than coil embolization. However, the flow-diverting device has also some risks, including rupture of aneurysm, intracerebral hemorrhage, and ischemic stroke. In addition, with more experience, unexpected complications are also reported.5)7) In the present case, we experienced a delayed ischemic stroke at 27 days after endovascular treatment. The patient had multiple aneurysms and, among them, we treated a large posterior communicating artery aneurysm using Pipeline™ Embolization Device. The patient was tolerable for 25 days, but then suddenly presented intermittent right hemiparesis. In the initial diffusion magnetic resonance imaging (MRI), there was no acute lesion; however, in the follow-up MRI, an acute ischemic stroke was found in the territory of anterior choroidal artery which was covered by Pipeline Embolization Device. We suspect that neo-intimal overgrowth or a tiny thrombus have led to this delayed complication. Through our case, we learned that the neurosurgeon should be aware of the possibility of delayed ischemic stroke after flow diversion, as well as, long-term close observation and follow-up angiography are necessary even in the event of no acute complications.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.