Aseptic Loosening After CD Instrumentation in the Treatment of Scoliosis

Wimmer, Cornelius; Głuch, H

doi:10.1097/00002517-199810000-00011

Cited by 25 publications

(24 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Infection is a common problem after spinal fusion in patients with CP. Our rate of 6% deep infection contrasts to the commonly observed 1% to 2% rate for adolescent idiopathic scoliosis [1,4], but is well within the range quoted in the literature [1,7,10,11]. The data on the rate of superficial infection are less clear, but at least another 4% of our patients had superficial infection.…”

Section: Discussionsupporting

confidence: 78%

Infection Rate after Spine Surgery in Cerebral Palsy is High and Impairs Results: Multicenter Analysis of Risk Factors and Treatment

Sponseller

Shah

Abel

et al. 2010

Clinical Orthopaedics &Amp; Related Research

103

View full text Add to dashboard Cite

Infection is a serious complication of surgery to correct scoliosis in patients with cerebral palsy (CP). We obtained multicenter representative figures for deep and superficial infection rates, analyzed risk factors and treatment outcomes, and compared deformity correction relative to infection. We retrospectively reviewed 157 patients who had posterior spinal fusion for CP at one of eight centers. Preoperative and intraoperative variables were subjected to multivariate analysis to determine factors predictive of infection. There were 16 wound infections (10%; nine deep, seven superficial). Only two study factors predicted infection: higher preoperative white blood cell count (8.5 versus 6.4 [in those without infection] 9 10 3 ) and use of a unit rod (15% versus 5% for bent rods). Fourteen patients underwent irrigation and débridement procedures. Five infections required 2 months or longer to resolve. Two had implant removal. Final curve correction was lower for those with deep infections than those without (67% versus 53%, respectively). We noted a trend toward greater percentages of pain at last followup in those with deep infection than in those without infection (50% versus 18%, respectively) but the study was not adequately powered to confirm this point. Our infection rate in scoliosis surgery for CP was higher than that for most elective spinal deformity surgery.

show abstract

Section: Discussionsupporting

confidence: 78%

Infection Rate after Spine Surgery in Cerebral Palsy is High and Impairs Results: Multicenter Analysis of Risk Factors and Treatment

Sponseller

Shah

Abel

et al. 2010

Clinical Orthopaedics &Amp; Related Research

103

View full text Add to dashboard Cite

show abstract

“…Gaine et al consider it possible that metallic debris and corrosion products from fretting at cross-connector junctions may provide the environment for the incubation of dormant or inactive endogenous microbes [6,16]. Histology demonstrated foreign-body reactions also in our patients.…”

Section: Discussionmentioning

confidence: 61%

“…In fact, none of the surgical revisions revealed clinical or histologic evidence of osteomyelitic processes. There is relative consensus in the literature that implant removal and short-term antibiotic therapy achieves uneventful healing with primary wound closure and that delayed closure is unnecessary [3,9,11,13,16]. This approach was curative also in our patients with late infections.…”

Section: Discussionmentioning

confidence: 75%

“…Glycocalyx, a membrane that surrounds bacteria adjacent to surgical implants, may cause difficulty in culturing bacteria and result in poor antibiotic penetration. Corrosion of bulky steel implants, fretting, pseudarthrosis formation, or implant micromovements have been associated with histologically confirmed extensive foreign body granulomas and superinfected synovial bursae [3,6,8,11,16]. Immunologic/allergologic responses to metal implants, triggered by denaturation of and conformational changes in endogenous proteins at the implant surface, have been implicated as well [14].…”

Section: Introductionmentioning

confidence: 99%

“…Complete instrumentation removal with subsequent primary wound closure and systemic antibiotics is usually curative [3,6,8,9,11,13,16]. Implant removal is problematic where insufficient bony fusion or pseudarthrosis requires spinal stabilization by reinstrumentation which, however, appears prone to complications because of the potentially infectious wound.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Implant removal for late-developing infection after instrumented posterior spinal fusion for scoliosis: reinstrumentation reduces loss of correction. A retrospective analysis of 45 cases

Muschik¹,

Lück²,

Schlenzka

2004

Eur Spine J

114

View full text Add to dashboard Cite

A retrospective follow-up study of patients who, having undergone instrumented posterior spinal fusion for scoliosis, experienced late infection and then underwent either implant removal alone or implant removal and instrumented refusion. We conducted this study to determine whether it is possible to avoid loss of correction by a single-stage implant removal and reinstrumentation procedure. There have been a few reports of late-appearing infections after spinal instrumentation. Implant bulk, metallurgic reactions, and contamination with low-virulence microorganisms have been suggested as possible etiologic factors. The clinical symptoms include pain, swelling, redness, and spontaneous drainage of fluid. Complete instrumentation removal and systemic antibiotics is usually curative. We retrospectively reviewed 45 patients who underwent instrumented posterior spinal fusion for scoliosis and experienced development of late infections and, after a mean of 3 years after the initial procedure, either underwent implant removal alone [n=35, instrumentation removal (HR) group] or additionally underwent reinstrumentation and fusion [n=10, reinstrumentation and fusion (RI&F) group]. Three patients were reinstrumented 1.5 years after

show abstract

Material dependent fretting corrosion in spinal fusion devices: Evaluation of onset and long‐term response

et al. 2018

View full text Add to dashboard Cite

Posterior spinal fusion implants include number of interconnecting components, which are subjected to micromotion under physiological loading conditions inducing a potential for fretting corrosion. There is very little known about the fretting corrosion in these devices in terms of the minimum angular displacement (threshold) necessary to induce fretting corrosion or the amount of fretting corrosion that can arise during the life of the implant. Therefore, the first goal was to evaluate the threshold fretting corrosion in three anatomical orientations and second the long-term fretting corrosion for the three different material types of spinal implants under physiological loading conditions. In threshold test, axial rotation exhibited highest changes in open circuit potential (V in mV) and induced fretting currents (I in µA) for cobalt chrome (ΔV : 24.71 ± 5.53; ΔI : 4.03 ± 0.51) and stainless steel (ΔV : 28.21 ± 6.97; ΔI : 2.98 ± 0.42) constructs whereas it was flexion-extension for titanium constructs (ΔV : 4.51 ± 2.48; ΔI : 0.38 ± 0.12). Long-term test indicated that the titanium (V :101 ± 0.06; I : 0.07 ± 0.02) and cobalt chrome (V : 140.67 ± 0.04; I : 0.12 ± 0.05) constructs were more resistant to the fretting corrosion compared to stainless steel (V : -135.33 ± 0.31; I : 2.63 ± 1.06). © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2858-2868, 2018.

show abstract

Aseptic Loosening After CD Instrumentation in the Treatment of Scoliosis

Cited by 25 publications

References 0 publications

Infection Rate after Spine Surgery in Cerebral Palsy is High and Impairs Results: Multicenter Analysis of Risk Factors and Treatment

Infection Rate after Spine Surgery in Cerebral Palsy is High and Impairs Results: Multicenter Analysis of Risk Factors and Treatment

Implant removal for late-developing infection after instrumented posterior spinal fusion for scoliosis: reinstrumentation reduces loss of correction. A retrospective analysis of 45 cases

Material dependent fretting corrosion in spinal fusion devices: Evaluation of onset and long‐term response

Contact Info

Product

Resources

About