Surgical outcomes of infectious spondylitis after vertebroplasty, and comparisons between pyogenic and tuberculosis

Liao, Jen‐Chung; Lai, Po‐Liang; Chen, Lih-Hui; Niu, Chi‐Chien

doi:10.1186/s12879-018-3486-x

Cited by 17 publications

(26 citation statements)

References 26 publications

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“…It requires major salvage surgery and may lead to residual disability and even death in several cases. In addition to standard skin preparation and the administration of prophylactic antibiotics, surgeons should preoperatively consider immune status, urinary tract infection or other infection source within 6 months, and history of pulmonary tuberculosis to prevent infection post vertebroplasty [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

An unusual Staphylococcus saccharolyticus spondylodiscitis post kyphoplasty: a case report

et al. 2020

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Background Staphylococcus saccharolyticus is a rarely encountered coagulase-negative, which grows slowly and its strictly anaerobic staphylococcus from the skin. It is usually considered a contaminant, but some rare reports have described deep-seated infections. Virulence factors remain poorly known, although, genomic analysis highlights pathogenic potential. Case presentation We report a case of Staphylococcus saccharolyticus spondylodiscitis that followed kyphoplasty, a procedure associated with a low rate but possible severe infectious complication (0.46%), and have reviewed the literature. This case specifically stresses the risk of healthcare-associated S. saccharolyticus infection in high-risk patients (those with a history of alcoholism and heavy smoking). Conclusion S. saccharolyticus infection is difficult to diagnose due to microbiological characteristics of this bacterium; it requires timely treatment, and improved infection control procedure should be encouraged for high-risk patients.

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Section: Discussionmentioning

confidence: 99%

An unusual Staphylococcus saccharolyticus spondylodiscitis post kyphoplasty: a case report

et al. 2020

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“…To minimize procedure-related infection while still providing an appropriate clinical benefit, it was safer to proceed with a lumbar TFESI, a quicker, lower-risk intervention with minimal needle manipulation and less equipment-patient interaction compared to a VA, which is a longer, higher-risk, more elaborate procedure with multiple device exchanges involving needle entry from the skin into the pedicle and vertebral body, which potentially increases the risk of infection complications. Infection rates vary in the literature, but the VA has been found to have more than twice the relative risk compared to ESIs [ 31 , 32 , 33 ]. Particularly in a relatively immunocompromised patient, it is prudent to minimize risk of potentially life-threatening infection.…”

Section: Discussionmentioning

confidence: 99%

Multidisciplinary Care of a Vertebral Fracture in a Patient with Hematopoietic Stem Cell Transplant: Safety Appropriateness in Interventional Pain Management and Rehabilitation Considerations

et al. 2022

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Bone loss leading to fragility fracture is a highly prevalent late effect in hematopoietic stem-cell transplant patients, who are affected 8–9 times more than the general population, particularly for vertebral compression fractures. Spinal interventions such as lumbar epidural steroid injections and vertebral augmentation may be helpful for providing pain relief and improved function, quality of life and return to ambulation. However, interventional procedures should be approached with caution in these patients. Our study found that there is a paucity of scientific studies addressing the risks of spinal injections in these patients and there is no absolute recommendation specific to spinal injections in patients receiving immunosuppressive agents or who have a history of solid organ or hematopoietic stem cell transplant. It is imperative to consider proper timing of the intervention to minimize risks while optimizing the benefits of the intervention combined with a well-defined post-transplant rehabilitation plan. Moreover, the decision to proceed with spinal interventions should be done case by case and with caution. Therefore, this article reports the case of a multidisciplinary treatment for a vertebral compression fracture in a patient with a hematopoietic stem-cell transplant, in particular discussing safety appropriateness in interventional pain management and rehabilitation considerations for this condition in this patient population.

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“…[2] Infection after vertebroplasty rarely occurs. Liao et al [10] reported the incidence of infection after vertebral augmentation is between 0% and 1%. Infection was ruled out in the present case by laboratory and pathological examination.…”

Section: Discussionmentioning

confidence: 99%

Vertebral collapse and polymethylmethacrylate breakage after vertebroplasty

et al. 2019

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Rationale: Vertebral augmentation has become the main treatment for osteoporotic vertebral fractures (VFs). In this article, we report a very rare case of vertebral collapse and polymethylmethacrylate (PMMA) breakage after vertebroplasty. We describe the clinical characteristics and revision surgery performed to remove the broken PMMA cement, maintain stability, and corrects the kyphotic deformity, and we analyze the possible causes. Patient concerns: A 72-year-old man who suffered back pain underwent first lumbar vertebra (L1) percutaneous vertebroplasty (PVP) due to osteoporosis and a vertebral fracture in May 2013. Postoperatively, the patient's back pain was markedly alleviated. Unfortunately, his lumbar back pain recurred in November 2015. Diagnoses: Plain radiographs showed collapse of the L1 vertebral body, breakage of the PMMA cement, and severe kyphosis at the thoracolumbar junction. Interventions: The posterior pedicle was internally fixed and an anterior artificial vertebral body implant was placed to maintain stability and correct the kyphotic deformity in a 2-step surgical procedure. Outcomes: The back pain was alleviated and the patient returned to daily life for more than two years. Lessons: This case demonstrates that PVP is not a simple minimally invasive surgery, and significant postsurgical care is necessary. The true cause of this rare phenomenon remains unclear, but the long-term use of steroids, new injuries, and poorly corrected kyphosis after PVP may play a role. Surgeons must be aware of the kinds of complications that may occur, including rare complications such as vertebral lysis.

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Surgical outcomes of infectious spondylitis after vertebroplasty, and comparisons between pyogenic and tuberculosis

Cited by 17 publications

References 26 publications

An unusual Staphylococcus saccharolyticus spondylodiscitis post kyphoplasty: a case report

An unusual Staphylococcus saccharolyticus spondylodiscitis post kyphoplasty: a case report

Multidisciplinary Care of a Vertebral Fracture in a Patient with Hematopoietic Stem Cell Transplant: Safety Appropriateness in Interventional Pain Management and Rehabilitation Considerations

Vertebral collapse and polymethylmethacrylate breakage after vertebroplasty

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