Postoperative spondylitis after posterior lumbar interbody fusion using cages

Ha, Kee-Yong; Kim, Young-Hoon

doi:10.1007/s00586-003-0584-1

Cited by 41 publications

(24 citation statements)

References 21 publications

(51 reference statements)

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“…16,20 In the study of Ha and Kim, 16 9 of the 10 patients were infected with such skin-related organisms. In our study, 6 of the 10 isolated microorganisms could have originated from the skin; however, the isolation of Pseudomonas aeruginosa from 2 patients, and Streptococcus faecalis and Acinetobacter baumannii each from 1 patient, suggests nosocomial infection acquisition.…”

Section: Discussionmentioning

confidence: 97%

“…This approach can be technically demanding, may cause neural injury and may destabilize the spine, 12,18,19 and disc space collapse and loss of normal lordosis are inevitable complications. 16 Maintaining internal fixation in the presence of infection is another therapeutic approach which has been recognized for at least 3 decades. Although bacterial culprits, once adhered to instrumentation may become difficult to eradicate by antibiotics, stability imparted by the implants has been shown to play an important role in controlling infection and supporting bony union.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Management of Deep Wound Infection After Posterior Lumbar Interbody Fusion With Cages

Mirovsky¹,

Floman²,

Smorgick³

et al. 2007

Journal of Spinal Disorders &Amp; Techniques

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Management of Deep Wound Infection After Posterior Lumbar Interbody Fusion With Cages

Mirovsky¹,

Floman²,

Smorgick³

et al. 2007

Journal of Spinal Disorders &Amp; Techniques

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“…Some authors noted that removal of implants and appropriate antibiotics was effective but accepted the consequent deformity [12,16,28]. Whereas others take the view that implants can be retained where stable and replaced primarily when loose, whilst carrying out debridement, with wound closure over multiple drains and that these operations can be done as a single procedure leading to a successful fusion and avoidance of deformity [4,7,17,18,24,27,29,32,33,41,44].…”

Section: Treatmentmentioning

confidence: 99%

Infections associated with spinal implants

Quaile

2012

International Orthopaedics (SICOT)

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Spinal infections represent a difficult challenge to treating clinicians. Infections in the presence of implants are even more so. In this review the literature appears to reflect a change of practice in which the aim is to retain implants if possible. The newer spinal procedures such as disc replacements pose different problems largely due to the more difficult access. The situation in the spine is more difficult than in general orthopaedics when dealing with infection due to the requirement for stability and to protect neurological function. The main thrust of management, therefore, is early diagnosis and a high index of suspicion followed by adequate if not radical management in a multidisciplinary setting. In the event prevention is better than cure and therefore consideration of the various mechanisms to avoid infection must be taken. There are some 'novel' considerations for the avoidance of infection alongside the tried and tested techniques. There are also new procedures for wound closure and the elimination of dead space.

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“…Una evaluación de 1680 pacientes con 3053 niveles fusionados con seguimiento de 5 años, han evaluado las causas de revisión que fueron pseudoartrosis, descompensación del segmento adyacente, re descompresión, falla del implante, espondilitis iatrogénica [4][5][6] . En los últimos años han salido publicaciones sobre el uso de una sola caja colocada por vía posterior pero en forma diagonal, como lo muestra Zhao et al 7 donde obtuvieron buena tasa de fusión.…”

Section: Introductionunclassified

Manejo de la migración posterior de los dispositivos intersomáticos colocados por vía posterior (PLIF): análisis bibliográfico

et al. 2011

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RESUMENObjetivo: Se tiene la finalidad de presentar el cuadro clínico de tres casos de esta complicación y analizar metodológicamente los trabajos existentes en la bibliografía. Método: Tres pacientes operados de columna lumbar a quienes se les realizó una artrodesis circunferencial y que presentaron en el posoperatorio, después de bastante tiempo, nueva sintomatología relacionada con la migración de uno o de los dos PLIF. Resultados: Se realizó mediante el abordaje por vía anterior retroperitoneal, para disectomía, retiro de material migrado y colocación de un dispositivo intersomático anterior. En el primer caso se asoció un abordaje posterior para el retiro del material de osteosíntesis. Se realizó una búsqueda bibliográfica para analizar los datos sobre el retiro según parámetros de evidencia científica. Conclusiones: No existen publicaciones de Evidencia tipo 1 o 2 que marquen directivas claras. La presencia de fibrosis posquirúrgica orientaría al abordaje por vía anterior en el retiro de los dispositivos intersomáticos y así evitaría las lesiones del saco dural y la elongación radicular. La dificultad del manejo vascular y el riesgo de eyaculación retrógrada en pacientes del sexo masculino son parámetros a tener en cuenta para optar por el abordaje posterior. El retiro de los PLIF migrados a posterior, que causen sintomatología dolorosa y/o deficitaria, se convierte en una práctica altamente exigente y de manejo dificultoso.Descriptores: Vértebras lumbares; Fusión vertebral; Procedimento quirúrgico minimamente invasivo. RESUMOObjetivo: Apresentar o quadro clínico de três casos dessa complicação e analisar metodologicamente os trabalhos presentes na literatura. Método: Três pacientes submetidos à cirurgia da coluna lombar na qual se realizou artrodese circunferencial e que apresentaram nova sintomatologia no pós-operatório tardio, relacionada com a migração de um ou dos dois PLIF. Resultados: Realizou-se por acesso retroperitoneal anterior, para discectomia, a retirada do material que migrou e a colocação de um dispositivo intersomático anterior. No primeiro caso, associou-se acesso posterior para a retirada do material de osteossíntese. Efetuou-se uma busca na literatura para analisar os dados sobre a retirada de acordo com parâmetros de evidência científica. Conclusões: Não existem publicações de evidências do tipo 1 ou 2 que marquem diretrizes claras. A presença de fibrose pós-cirúrgica orientaria o acesso anterior na retirada dos dispositivos intersomáticos e, assim, evitaria as lesões do saco dural e o alongamento radicular. A dificuldade da manipulação vascular e o risco de ejaculação retrógrada em pacientes do sexo masculino são parâmetros a considerar ao escolher o acesso posterior. A retirada dos PLIF migrados para posterior que causam sintomatologia dolorosa e/ou deficiência torna essa prática altamente exigente e difícil.

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Postoperative spondylitis after posterior lumbar interbody fusion using cages

Cited by 41 publications

References 21 publications

Management of Deep Wound Infection After Posterior Lumbar Interbody Fusion With Cages

Management of Deep Wound Infection After Posterior Lumbar Interbody Fusion With Cages

Infections associated with spinal implants

Manejo de la migración posterior de los dispositivos intersomáticos colocados por vía posterior (PLIF): análisis bibliográfico

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