Risk factors for perioperative morbidity in spine surgeries of different complexities: a multivariate analysis of 1,009 consecutive patients

Farshad, Mazda; Bauer, David Ephraim; Wechsler, C.; Gerber, Christian; Aichmair, Alexander

doi:10.1016/j.spinee.2018.02.003

Cited by 23 publications

(13 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Studies published aiming at predicting risks of unfavourable results in spine surgery, all lack information of which alloy the metal work used was made from and therefore they are not informative in this regard [17,18]. On the contrary, there is one clinical series published comprising a limited number of patients in which revision due to late infected stainless steel to a titanium-based implants in one surgery was used, with full success in 10/10 cases, supporting our hypothesis in a clinical setting [4].…”

Section: Discussionmentioning

confidence: 99%

Titanium granules pre-treated with hydrogen peroxide inhibit growth of bacteria associated with post-operative infections in spine surgery

et al. 2018

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Titanium granules pre-treated with hydrogen peroxide inhibit growth of bacteria associated with post-operative infections in spine surgery

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Likewise, community-acquired spine infections (SI) are associated with enhanced morbidity; costs and prolonged hospital stay for the patients [1]. Most scientific papers are rather interested in the epidemiology of SI and risk factors for surgical site infections after spine surgery [2], occurring at 1% to 3% [2][3][4], rather than the modalities and outcomes of their treatment.…”

Section: Background and Rationalementioning

confidence: 99%

“…Some of these risk factors influence the occurrence of infection only indirectly and act as a confounding element; e.g. fusion surgery, particularly if involving the lumbosacral spine and length of surgery are associated with high blood [2], which itself may become an independent risk factor for infection. This remains the domain of infection control.…”

Section: Background and Rationalementioning

confidence: 99%

Protocol of a short post-surgical antibiotic therapy in spine infections - prospective, randomized, unblinded, non-inferiority trials(SASI trials)

Betz

Uçkay

Schüpbach

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

Background There are several open scientific questions regarding the optimal antibiotic treatment of spine infections (SI) with or without an implant. The duration of post-surgical antibiotic therapy is debated.Methods We will perform and perform two unblinded randomized -controlled RCTs. We hypothesize that shorter durations of systemic antibiotic therapy after surgery for SI are non-inferior (10% margin, 80% power, ɑlpha 5%) to existing (long) treatment durations. The RCTs allocate the participants in two arms of 2 x 59 episodes each: 3 vs. 6 weeks of targeted post-surgical systemic antibiotic therapy for implant-free spine infections (two positive microbiological samples); or 6 vs. 12 weeks for implant-related spine infections. This equals a total of 236 adult SI episodes (randomization schemes 1:1) with a minimal follow-up of 12 months. All participants have a concomitant multidisciplinary surgical, re-educational, internist and infectious diseases care. We perform three interim analyses that are evaluated, in a blinded analysis, by an independent Study Data Monitoring Committee. Besides the primary outcome remission, we also assess adverse events of antibiotic therapy, changes of the patient’s nutritional status, the influence of immune suppression, total costs, functional scores, and the timely evolution of the (surgical) wounds. We define infection as the presence of local signs of inflammation (pus, wound discharge, calor, rubor) together with microbiological evidence of the same pathogen(s) in at least two intraoperative samples; and remission as absence of clinical, laboratory and/or radiological evidence of (former or new) infection.Discussion Provided that there is adequate surgical debridement, both RCTs enable to potentially prescribe less antibiotics during the therapy of SI; with potentially less adverse events and reduced overall costs.

show abstract

“…Likewise, community-acquired spinal infections (SIs) are associated with increased morbidity and costs and prolonged hospital stay for the patients [1]. Most scientific papers are interested in the epidemiology of SI and risk factors for surgical site infections after spinal surgery [2], occurring at 1-3% [2][3][4], rather than the modalities and outcomes of treatment. Risk factors leading to infection may be multiple.…”

Section: Introductionmentioning

confidence: 99%

“…Some of these risk factors influence the occurrence of infection only indirectly and act as a confounding element. For example, fusion surgery, particularly if it involves the lumbosacral spine, and length of surgery are associated with high blood loss [2], which itself may become an independent risk factor for infection. This remains the domain of infection control.…”

Section: Introductionmentioning

confidence: 99%

Short postsurgical antibiotic therapy for spinal infections: protocol of prospective, randomized, unblinded, noninferiority trials (SASI trials)

Betz

Uçkay

Schüpbach

et al. 2020

Trials

Self Cite

View full text Add to dashboard Cite

Background: There are several open scientific questions regarding the optimal antibiotic treatment of spinal infections (SIs) with or without an implant. The duration of postsurgical antibiotic therapy is debated. Methods: We will perform two unblinded randomized controlled trials (RCTs). We hypothesize that shorter durations of systemic antibiotic therapy after surgery for SI are noninferior (10% margin, 80% power, α = 5%) to existing (long) treatment durations. The RCTs allocate the participants to two arms of 2 × 59 episodes each: 3 vs. 6 weeks of targeted postsurgical systemic antibiotic therapy for implant-free SIs or 6 vs. 12 weeks for implant-related SIs. This equals a total of 236 adult SI episodes (randomization scheme 1:1) with a minimal follow-up of 12 months. All participants receive concomitant multidisciplinary surgical, re-educational, internist, and infectious disease care. We will perform three interim analyses that are evaluated, in a blinded analysis, by an independent study data monitoring committee. Besides the primary outcome of remission, we will also assess adverse events of antibiotic therapy, changes of the patient's nutritional status, the influence of immune suppression, total costs, functional scores, and the timely evolution of the (surgical) wounds. We define infection as the presence of local signs of inflammation (pus, wound discharge, calor, and rubor) together with microbiological evidence of the same pathogen(s) in at least two intraoperative samples, and we define remission as the absence of clinical, laboratory, and/or radiological evidence of (former or new) infection. Discussion: Provided that there is adequate surgical debridement, both RCTs will potentially enable prescription of less antibiotics during the therapy of SI, with potentially less adverse events and reduced overall costs.

show abstract

Risk factors for perioperative morbidity in spine surgeries of different complexities: a multivariate analysis of 1,009 consecutive patients

Cited by 23 publications

References 24 publications

Titanium granules pre-treated with hydrogen peroxide inhibit growth of bacteria associated with post-operative infections in spine surgery

Titanium granules pre-treated with hydrogen peroxide inhibit growth of bacteria associated with post-operative infections in spine surgery

Protocol of a short post-surgical antibiotic therapy in spine infections - prospective, randomized, unblinded, non-inferiority trials(SASI trials)

Short postsurgical antibiotic therapy for spinal infections: protocol of prospective, randomized, unblinded, noninferiority trials (SASI trials)

Contact Info

Product

Resources

About