Re: Infection after vertebroplasty or kyphoplasty. A series of nine cases and review of literature. Spine J 13:1809–17

Chen, Yen-Jen; Chen, Huiyi; Hsu, Horng‐Chaung

doi:10.1016/j.spinee.2014.01.057

Cited by 4 publications

(4 citation statements)

References 5 publications

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“…Most cases of post-VP pyogenic spondylitis developed days to months after VP and most cases of post-VP TB spondylitis happened months to years after VP, this scenario was similar in our and Park’s study. In contrast to Park’s study, we had no cases of post-VP TB spondylitis happened within days to weeks after initial VP, but there were two cases among Park’s review; Park et al thought the etiology of these two cases was pre-existed TB spondylitis and was misdiagnosed as simple osteoporosis compression fracture by theory of Chen et al [ 27 ].…”

Section: Discussionmentioning

confidence: 77%

Surgical outcomes of infectious spondylitis after vertebroplasty, and comparisons between pyogenic and tuberculosis

et al. 2018

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BackgroundInfection after vertebroplasty (VP) is a rare but serious complication. Previous literatures showed most pathogens for infection after VP were bacteria; tuberculosis (TB) induced infection after VP was extremely rare. We reported our treatment experiences of cases with infectious spondylitis after VP, and compared the differences between developed pyogenic and TB spondylitis.MethodsFrom January 2001 to December 2015, 5749 patients had undergone VP at our department were reviewed retrospectively. The causative organisms were obtained from tissue culture of revision surgery. Parameters including type of surgery, the interval between VP and revision surgery, neurologic status, and visual analog scale (VAS) of back pain were recorded. Laboratory data at the time of VP and revision surgery were collected. Charlson comorbidity index (CCI), preoperative bacteremia, urinary tract infection (UTI), pulmonary TB history were also analyzed.ResultsEighteen patients were confirmed with developed infectious spondylitis after VP (0.32%, 18/5749). Two were male and 16 were female. The median age at VP was 73.4 years. Nine patients were TB and the other nine patients were pyogenic. The interval between VP and revision surgery ranged from 7 to 1140 days (mean 123.2 days). The most common type of revision surgery was anterior combined with posterior surgery. Seven patients developed neurologic deficit before revision surgery. Three patients died within 6 months after revision surgery, with a mortality of 16.7%. Finally, VAS of back pain was improved from 7.4 to 3.1. Seven patients could walk normally, the other 8 patients had some degree of disability. Both pyogenic and TB group had similar age, sex, and CCI distribution. The interval between VP and revision surgery was shorter in the patients with pyogenic organisms (75.9 vs 170.6 days). At revision surgery, WBC and CRP were prominently elevated in the pyogenic group. Five in the pyogenic group had UTI and bacteremia; five in TB group had a history of lung TB.ConclusionsInfection spondylitis after VP required major surgery for salvage with a relevant part of residual disability. Before VP, any bacteremia/UTI or history of pulmonary TB should be reviewed rigorously; any elevation of infection parameters should be scrutinized strictly.

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Section: Discussionmentioning

confidence: 77%

Surgical outcomes of infectious spondylitis after vertebroplasty, and comparisons between pyogenic and tuberculosis

et al. 2018

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“…Previous studies have shown that although the incidence of pyogenic spondylitis after VA is not high, the consequences are serious. [ 4 ] Due to the presence of polymethylmethacrylate (PMMA), conventional antiinfective treatment measures are insufficient, and surgery inevitably becomes one of the main treatment methods for such patients. Currently, relevant studies on pyogenic spondylitis after VA surgery mainly focus on the high risk factors of postoperative infection, clinical manifestations after infection and clinical diagnosis;[ 4 , 5 ] however, there is no in-depth study on the surgical treatment of such patients.…”

Section: Introductionmentioning

confidence: 99%

A rare case of aggressive pyogenic spondylitis with giant abscesses after vertebral augmentation

Liu,

He,

Long

et al. 2023

Jt Dis Relat Surg

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Although Streptococcus constellatus (SC), an opportunistic pathogen, can cause abscesses and empyema. The SC infection after vertebral augmentation (VA) can interfere with patients' daily living activities and can be life-threatening in severe cases. A 67-year-old male complained of lumbar pain for two months. The patient underwent percutaneous vertebroplasty of the second and third lumbar vertebrae two months ago. On admission, laboratory and imaging evidence suggested infection of the second and third lumbar vertebrae with bilateral psoas major and left lumbodorsal abscesses. After three weeks of empirical anti-infective therapy, abscess removal and the second and third lumbar vertebrae fusion with iliac bone graft were performed under general anesthesia. Intraoperative pathology and next-generation sequencing (NGS) examination of the pus suggested SC infection, and oral linezolid was given for 12 weeks after surgery. The infection was eventually cured and the patient achieved satisfactory function. In conclusion, pyogenic spondylitis due to SC infection after VA is a life-threatening complication. In addition to infectious disease consultation and routine etiological screening, NGS is important to identify infection with unknown pathogens. Surgery combined with sensitive antibiotics is appropriate for patients with progressive neurological deficits.

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“…Despite the extensive development of VA, preventing multiple complications related to surgery is still a key issue that cannot be ignored in improving clinical efficacy. Previous studies reported that the incidence of pyogenic spondylitis after vertebral augmentation (PSVA) fluctuated at 0–1.6 %, which was low, but the consequences were severe and even threatened the lives of patients [ 2 – 4 ]. At present, most of the relevant studies on PSVA are case reports.…”

Section: Introductionmentioning

confidence: 99%

Debridement and corpectomy via single posterior approach to treat pyogenic spondylitis after vertebral augmentation

Zhang

Wang

et al. 2021

BMC Musculoskelet Disord

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Background Infection after vertebral augmentation (VA) often limits the daily activities of patients and even threatens their life. The operation may be one of the effective treatments if the patient suffers from intolerable severe pain, neurological deficits, and damage to spinal stability. This study aimed to investigate the clinical efficacy of the treatment of pyogenic spondylitis after vertebral augmentation (PSVA) with Single posterior debridement, vertebral body resection, and intervertebral bone graft fusion and internal fixation (sPVRIF). Methods The study was performed on 19 patients with PSVA who underwent VA at 4 hospitals in the region between January 2010 and July 2020. Nineteen patients were included. Among them, 16 patients underwent sPVRIF to treat the PSVA. Results A total of 2267 patients underwent VA at 4 hospitals in the region. Of the 19 patients with postoperative PSVA, suppurative spondylitis was misdiagnosed as an osteoporotic vertebral fracture(OVF) in 4 patients and they underwent VA. Besides osteoporosis, 18 patients had other comorbidities. The average interval between the first surgery and the diagnosis of PSVA was 96.4 days. Of the 19 patients, 16 received surgical treatment. The surgical time was 175.0±16.8 min, and the intraoperative blood loss was 465.6±166.0 mL. Pathogenic microorganisms were cultured in 12 patients. Conclusion PSVA is a severe complication that can even threaten the life of the patients. sPVRIF may be one of the effective treatments if the patient suffers from intolerable severe pain, neurological deficits, and damage to spinal stability.

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Re: Infection after vertebroplasty or kyphoplasty. A series of nine cases and review of literature. Spine J 13:1809–17

Cited by 4 publications

References 5 publications

Surgical outcomes of infectious spondylitis after vertebroplasty, and comparisons between pyogenic and tuberculosis

Surgical outcomes of infectious spondylitis after vertebroplasty, and comparisons between pyogenic and tuberculosis

A rare case of aggressive pyogenic spondylitis with giant abscesses after vertebral augmentation

Debridement and corpectomy via single posterior approach to treat pyogenic spondylitis after vertebral augmentation

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