Infection Rate After Minimally Invasive Noninstrumented Spinal Surgery Based on 4350 Procedures

Shousha, Mootaz; Cirovic, Dusan; Boehm, Heinrich

doi:10.1097/brs.0000000000000690

Cited by 30 publications

(31 citation statements)

References 18 publications

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“…Data in the present study are consistent with those in previous reports evaluating minimally invasive techniques. 20,26,28,38 In a retrospective study using an administrative database, McGirt and colleagues 20 reported that their minimally invasive technique was associated with a decrease in the incidence of SSI following 2-level posterior/transforaminal lumbar interbody fusion. O'Toole and colleagues postulated several possible reasons for the lower risk of SSI associated with minimally invasive surgery: reduced exposure of deep tissue, preventive effect of a tubular retractor for local contamination, smaller incisions, and reduced dead space in the surgical site after closure.…”

Section: Discussionmentioning

confidence: 99%

Does the microendoscopic technique reduce mortality and major complications in patients undergoing lumbar discectomy? A propensity score–matched analysis using a nationwide administrative database

Ohya¹,

Oshima²,

Chikuda³

et al. 2016

FOC

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OBJECTIVE Although minimally invasive spinal surgery has recently gained popularity, few nationwide studies have compared the adverse events that occur during endoscopic versus open spinal surgery. The purpose of this study was to compare perioperative complications associated with microendoscopic discectomy (MED) and open discectomy for patients with lumbar disc herniation. METHODS The authors retrospectively extracted from the Diagnosis Procedure Combination database, a national inpatient database in Japan, data for patients admitted between July 2010 and March 2013. Patients who underwent lumbar discectomy without fusion surgery were included in the analysis, and those with an urgent admission were excluded. The authors examined patient age, sex, Charlson Comorbidity Index, body mass index, smoking status, blood transfusion, duration of anesthesia, type of hospital, and hospital volume (number of patients undergoing discectomy at each hospital). One-to-one propensity score matching between the MED and open discectomy groups was performed to compare the proportions of in-hospital deaths, surgical site infections (SSIs), and major complications, including stroke, acute coronary events, pulmonary embolism, respiratory complications, urinary tract infection, and sepsis. The authors also compared the hospital length of stay between the 2 groups. RESULTS A total of 26,612 patients were identified in the database. The mean age was 49.6 years (SD 17.7 years). Among all patients, 17,406 (65.4%) were male and 6422 (24.1%) underwent MED. A propensity score–matched analysis with 6040 pairs of patients showed significant decreases in the occurrence of major complications (0.8% vs 1.3%, p = 0.01) and SSI (0.1% vs 0.2%, p = 0.02) in patients treated with MED compared with those who underwent open discectomy. Overall, MED was associated with significantly lower risks of major complications (OR 0.62, 95% CI 0.43–0.89, p = 0.01) and SSI (OR 0.29, 95% CI 0.09–0.87, p = 0.03) than open discectomy. There was a significant difference in length of hospital stay (11 vs 15 days, p < 0.001) between the groups. There was no significant difference in in-hospital mortality between MED and open discectomy. CONCLUSIONS The microendoscopic technique was associated with lower risks for SSI and major complications following discectomy in patients with lumbar disc herniation.

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Section: Discussionmentioning

confidence: 99%

Does the microendoscopic technique reduce mortality and major complications in patients undergoing lumbar discectomy? A propensity score–matched analysis using a nationwide administrative database

Ohya¹,

Oshima²,

Chikuda³

et al. 2016

FOC

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“…36 For instance, overall infection rates in noninstrumented minimally invasive spine surgeries are markedly reduced, 0.09%, compared with the incidence in the present analysis. 37 Additionally, complication rates will vary based on the type of procedure and medical indication.…”

Section: Discussionmentioning

confidence: 99%

Risk Modeling Predicts Complication Rates for Spinal Surgery

Kimmell

Algattas

Joynt

et al. 2015

SPINE

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“…[28] In this report series, Klebsiella pneumonia infection developed de novo post operative without gastrourinary trauma/associated infection per se thus was worth reporting. The infection rates after MISS the reported rates are 0.09% to 1% [29,30,31] . Concerns regarding the challenges a surgeon faces during initial experience with these systems.…”

Section: Discussionmentioning

confidence: 98%

Does Spondylodiscitis Follow All Its Parameters? - Report of Three Atypical Cases

Roy¹

2017

jmscr

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Vertebral osteomyelitis or spondylodiscitis is 2-7% of osteomyelitis. Iatrogenic spondylodiscitis accounts for 1-11%. Common organism is Staphylococcus aureus and usually the mean time from onset of symptoms to diagnosis has been reported to range from 8 weeks to 3 months. Worsening back pain with reduced spinal ROM is sine qua non on iatrogenic spondylodiscitis. CRP and ESR are most important prognostic factors of treatment. In this report I present three cases one which started florid infections and its signs and symptoms much later than documented times after operation, one who developed post procedural discitis by an atypical bacteria without any definite cause of it to do it, one with indolent tunneling infection of the vertebral body after minimally invasive discectomy without any considerable alteration in clinicalfunctioning but with alteration radiologically and biochemically.

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Infection Rate After Minimally Invasive Noninstrumented Spinal Surgery Based on 4350 Procedures

Abstract: 4.

Cited by 30 publications

References 18 publications

Does the microendoscopic technique reduce mortality and major complications in patients undergoing lumbar discectomy? A propensity score–matched analysis using a nationwide administrative database

Does the microendoscopic technique reduce mortality and major complications in patients undergoing lumbar discectomy? A propensity score–matched analysis using a nationwide administrative database

Risk Modeling Predicts Complication Rates for Spinal Surgery

Does Spondylodiscitis Follow All Its Parameters? - Report of Three Atypical Cases

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