No more tears from surgical site infections in interventional pain management

Lim, Seungjin; Yoo, Yeong Min; Kim, Kyung-Hoon

doi:10.3344/kjp.22397

Cited by 3 publications

(3 citation statements)

References 143 publications

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“…Imaging modalities such as MRI and CT scans demonstrated high diagnostic accuracy in detecting SSI (Di Saverio et al, 2020). Early recognition of SSI symptoms and remarkably increasing pain is crucial for timely intervention, as emphasized in several studies (Baniasadi et al, 2023;Hegde et al, 2012;Lim et al, 2023). A study investigated the impact of perioperative glucose control on SSI rates in diabetic patients undergoing spinal surgery, emphasizing the role of glycemic management in infection prevention (Blood et al, 2017) following posterior lumbar fusion surgery, emphasizing the importance of preoperative risk assessment in infection prevention (Li et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

Postoperative Infections of the Lumbar Spine: Presentation and Management

KHAN,

MUNIR,

ULLAH

et al. 2024

Biol Clin Sci Res J

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: Postoperative infections of the lumbar spine pose significant challenges in clinical management and patient outcomes. Despite advances in surgical techniques and perioperative care, these infections continue to occur, leading to increased morbidity and healthcare costs. Understanding the presentation and management of these infections is crucial for optimizing patient care and outcomes. The objective of the study is to assess the prevalence of spinal surgeries, comorbidities, diagnostic modalities, treatment approaches, and their correlations in managing surgical site infections among patients at Khyber Teaching Hospital. Medical records of 800 patients who underwent lumbar spine surgery at Khyber Teaching Hospital from 2020 to 2022 were retrospectively reviewed. Data regarding patient demographics, surgical details, infection characteristics, microbiological findings, treatment modalities, and outcomes were collected and analyzed. Descriptive statistics were used to summarize the findings, and inferential statistics were employed to explore associations between variables. The study comprised 800 spinal surgery patients at Khyber Teaching Hospital, with a mean age of 58 ± (12.3 SD) years. Laminectomy was the most common procedure (43.75%), followed by discectomy (22.5%). Clinical inspection was predominantly used for SSI diagnosis (95.6%), and post-surgical measures included debridement, antibiotics and cultures. Correlation analysis revealed varying associations between surgeries and post-operative symptoms. The Treatment outcomes showed high-resolution rates, with surgical debridement demonstrating the highest efficacy. This study reveals laminectomy as the most common procedure. As laminectomy was the most common procedure done, that’s why SSI was more common in these procedures. Key diagnostic methods for detecting surgical site infections (SSI) was clinical examination of wound status and pus discharge. The study revealed that patients with early surgical debridement had the best outcome in early resolution of infection and wound healing. Thus, Correlation analysis between surgeries and symptoms guides clinical decisions, with surgical debridement followed by antibiotics showing the highest efficacy in resolving infections. These findings stress the need for tailored patient care strategies to enhance outcomes and reduce complications in spinal surgery.

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Section: Discussionmentioning

confidence: 99%

Postoperative Infections of the Lumbar Spine: Presentation and Management

KHAN,

MUNIR,

ULLAH

et al. 2024

Biol Clin Sci Res J

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“…Although we attempted to measure this morphological parameter on the lumbar axial images that best showed the vertebral body at the L5 level, the single MRI slices we analyzed to measure the cross-sectional areas could have been inhomogeneous because of differences in the MRI cutting angles resulting from technical problems or individual anatomic variations. Fourth, LSL represents a combination of complex pathogenic causes, including spondylolisthesis, disc degeneration, and body mass index [20][21][22][23][24] ; however, we focused only on VBCSA. Future studies should evaluate the association between direct extrinsic mechanical compression and intrinsic changes.…”

Section: Discussionmentioning

confidence: 99%

Optimal cutoff point of vertebral body cross-sectional area as a morphological parameter for predicting lumbar spondylolysis

Park,

Song,

et al. 2023

Medicine

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The relationship between vertebral body cross-sectional area (VBCSA) and spinal conditions associated with increased lumbar lordosis, such as lumbar spondylolysis (LSL), is not known. We investigated the morphological parameter, VBCSA, to predict LSL. The VBCSA on MRI has not been studied for its association with LSL. We hypothesized that VBCSA is an important morphological parameter for LSL prediction. We collected VBCSA data from 90 patients (43 males and 47 females) with LSL and 91 control subjects (44 males and 47 females) who underwent lumbar spine magnetic resonance imaging (LS-MRI). Axial T2-weighted LS-MRI images were obtained from all participants. Using our picture archiving and communications system, we analyzed the VBCSA at the level of the L5 vertebral body by utilizing MRI. The average VBCSA was 2263.51 ± 306.02 mm2 in the male control group and 1820.92 ± 224.89 mm2 in the male LSL group. LSL patients had significantly lower VBCSAs (P < .001) than did the male controls. The average VBCSA was 1985.21 ± 258.05 mm2 in the female control group and 1553.73 ± 250.02 mm2 in the female LSL group, and the LSL patients also had significantly lower VBCSAs (P < .001) than did the female controls. The optimal VBCSA cutoff value in the male group was 2014.69 mm2 with 76.7% sensitivity, 75.0% specificity, and an area under the receiver operating curve (AUC) of 0.89 (95% CI: 0.82–0.95). In the female group, the optimal cutoff score was 1814.11 mm2 with 76.6% sensitivity, 76.6% specificity, and an AUC of 0.88 (95% CI: 0.82–0.95). VBCSA is a sensitive objective morphological parameter for assessing LSL, and a lower VBCSA is associated with a higher possibility of LSL. We believe that these results will be useful in diagnostic radiology for evaluating patients with LSL.

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“…There are 4 different approaches for the treatment of spondylodiscitis, psoas abscess, epidural abscess, and facet joint infection using a spinal endoscope and epiduroscope [ 39 ]. Basically, spinal infections are treated with medical treatment after confirmation of the causative agent [ 46 ]. According to the sites of combined infection (commonly spondylodiscitis, epidural abscess with septic arthritis of the facet joint), spinal endoscopic and/or epiduroscopic debridement and irrigation, followed by biopsy to discover the causative agent, is a minimally invasive procedure in debilitated and septic patients under safe sedation using dexmedetomidine [ 47 ].…”

Section: Main Bodymentioning

confidence: 99%

Facet joint disorders: from diagnosis to treatment

Yoo,

Kim

2023

Korean J Pain

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One of the most common sources of spinal pain syndromes is the facet joints. Cervical, thoracic, and lumbar facet joint pain syndromes comprise 55%, 42%, and 31% of chronic spinal pain syndromes, respectively. Common facet joint disorders are degenerative disorders, such as osteoarthritis, hypertrophied superior articular process, and facet joint cysts; septic arthritis; systemic and metabolic disorders, such as ankylosing spondylitis or gout; and traumatic dislocations. The facet pain syndrome from osteoarthritis is suspected from a patient’s history (referred pain pattern) and physical examination (tenderness). Other facet joint disorders may cause radicular pain if mass effect from a facet joint cyst, hypertrophied superior articular process, or tumors compress the dorsal root ganglion. However, a high degree of morphological change does not always provoke pain. The superiority of innervating nerve block or direct joint injection for diagnosis and treatment is still a controversy. Treatment includes facet joint injection in facet joint osteoarthritis or whiplash injury provoking referred pain or decompression in mass effect in cases of hypertrophied superior articular process or facet joint cyst eliciting radicular pain. In addition, septic arthritis is treated using a proper antibiotic, based on infected tissue or blood culture. This review describes the diagnosis and treatment of common facet joint disorders.

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No more tears from surgical site infections in interventional pain management

Cited by 3 publications

References 143 publications

Postoperative Infections of the Lumbar Spine: Presentation and Management

Postoperative Infections of the Lumbar Spine: Presentation and Management

Optimal cutoff point of vertebral body cross-sectional area as a morphological parameter for predicting lumbar spondylolysis

Facet joint disorders: from diagnosis to treatment

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