scholarly journals Screw Loosening in Posterior Spine Fusion: Prevalence and Risk Factors

2019 ◽  
Vol 10 (5) ◽  
pp. 598-602
Author(s):  
Laura Marie-Hardy ◽  
Hugues Pascal-Moussellard ◽  
Anne Barnaba ◽  
Raphael Bonaccorsi ◽  
Caroline Scemama
Keyword(s):  
Risk Factors ◽  
Spinal Fusion ◽  
Demographic Data ◽  
Significant Risk ◽  
Posterior Spinal Fusion ◽  
Sagittal Imbalance ◽  
Screw Loosening ◽  
Logistic Regression Models ◽  
Pull Out ◽  
American Society

Study Design: Retrospective cohort study. Objective: Screw loosening in spinal fusion is poorly defined. Accordingly, its prevalence rates range from 1% to 60%, and its risk factors remain undefined. The goal of this study was to assess the prevalence of screw loosening, according to precise definitions, and to identify factors associated with it. Methods: We retrospectively reviewed records for 166 patients who underwent a posterior spinal fusion in our institution between 2011 and 2016. We recorded demographic data, osteoporosis, pelvic balance, surgery-related information, and postoperative radiographic data at a minimum follow-up of 6 months. Univariable and multivariable logistic regression models were used. Significance was defined by P < .05. Results: When loosening was defined by partial pull-out, its prevalence was 9.6% (95% CI 5.6-15); thoracic localization, the use of CrCo (chromium-cobalt) rods, osteoporosis, PI/LL (pelvic incidence/lumbar lordosis) mismatch (preoperative), and frontal imbalance (preoperative) were significant risk factors. When loosening was defined by osteolysis (radiolucent rim) >1 mm around at least 1 screw, its prevalence was 40.4% (95% CI 33-48) and age, scoliosis as indication for fusion, ASA (American Society of Anesthesiologists) 2 or 3, the use of CrCo rods, more than 5 levels fused, no circumferential arthrodesis, postoperative bracing, and sacrum or ilium as the inferior level of instrumentation were also significant risk factors. Conclusions: A clear definition of screw loosening seems essential for a useful analysis of the literature. Osteoporosis, sagittal imbalance, and rigid material appear to be risk factors, regardless of the definition.

Incidence of Pleural Fluid and Its Associated Risk Factors After Posterior Spinal Fusion in Patients With Adolescent Idiopathic Scoliosis

Spine ◽  
2017 ◽  
Vol 42 (8) ◽  
pp. 603-609 ◽  
Author(s):  
Kazunori Hayashi ◽  
Hidetomi Terai ◽  
Hiromitsu Toyoda ◽  
Akinobu Suzuki ◽  
Masatoshi Hoshino ◽  
...  
Keyword(s):  
Risk Factors ◽  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Spinal Fusion ◽  
Pleural Fluid ◽  
Posterior Spinal Fusion ◽  
Associated Risk Factors

scholarly journals Temporary hemiepiphysiodesis using an eight‐plate implant for coronal angular deformity around the knee in children aged less than 10 years: efficacy, complications, occurrence of rebound and risk factors

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Zhen-Zhen Dai ◽  
Zhen-Peng Liang ◽  
Hao Li ◽  
Jing Ding ◽  
Zhen-Kai Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Deformity Correction ◽  
Genu Valgum ◽  
Angular Deformity ◽  
Screw Loosening ◽  
Logistic Regression Models ◽  
The Mean ◽  
Low Incidence ◽  
Angular Deformities

Abstract Background Temporary hemiepiphysiodesis (TH) using an eight-Plate implant is one of the most common surgeries used for the correction of coronal angular deformities around the knee in adolescents. However, few studies have focused on children aged less than 10 years treated with TH using an eight-Plate implant. The purpose of this study was to investigate the efficacy, correction velocity, and complications of TH with an eight-Plate implant as well as the occurrence of rebound and risk factors in this population. Methods This retrospective study included a total of 135 physes (101 knees) from 66 children (mean age of 4.69 years old, range from 1 to 10 years old) who underwent TH with an eight-Plate implant to correct coronal genu angular deformities in our hospital. Related clinical factors were recorded and analysed by multivariable linear and logistic regression models. Results The mean deformity correction period was 13.26 months, and the mean follow-up after eight-Plate removal was 12.71 months. In all, 94.06% (95/101 knees) of the genu angular deformities were completely corrected. Non-idiopathic genu angular deformity was found to be an independent risk factor for deformity correction failure (odds ratio (OR) = 2.47). The femoral correction velocity was significantly higher than the tibial correction velocity (1.28° vs. 0.83° per month, p < 0.001). After adjustment for other factors, younger children had higher correction velocities in the distal femur; however, genu valgum and idiopathic deformities were associated with higher correction velocities in the proximal tibia. In addition, we found three (3/101, 2.97%) knees with genu valgum that experienced rebound after removal of the eight-Plate, while five (5/101, 4.95%) knees with non-idiopathic genu angular deformity experienced screw loosening. No other complications were found, and non-idiopathic deformity was the only risk factor for complications (OR = 3.96). No risk factor was found for rebound in our study. Conclusions TH using an eight-Plate implant is an effective procedure for coronal genu angular deformities with a low incidence of complications and rebound in patients younger than 10 years old. For this population, TH using an eight-Plate should be considered as soon as the deformity stops responding to conservative treatments. The parents of children younger than 10 years of age with non-idiopathic deformities should be informed preoperatively that the deformity may be prone to correction failure or screw loosening after eight-Plate implantation.

scholarly journals A Critical Analysis of Risk Factors for Selected Tropical Diseases

2021 ◽  
Author(s):  
Faith-Michael Uzoka ◽  
Christie Akwaowo ◽  
Chinyere Nwafor Okoli ◽  
Victory Ekpin ◽  
Chukwudi Nwokoro ◽  
...  
Keyword(s):  
Risk Factors ◽  
Typhoid Fever ◽  
Demographic Data ◽  
Significant Risk ◽  
Personal Hygiene ◽  
Individual Risk ◽  
Tropical Diseases ◽  
Economic Implications ◽  
Frequency Distributions ◽  
The Individual

Abstract Aim: The aim of this study was to examine the impacts of different (non-clinical) risk factors on the populations’ predisposition to tropical diseases specifically Malaria, yellow fever, typhoid fever, chicken pox, measles, hepatitis B and UTI.Subject and Methods: Data for this study was obtained through patient diagnosis forms, distributed to physicians in Nigeria. A total of 2199 patient consultation forms were returned by 102 (out of 125) physicians, and considered useful for analysis. Demographic data of patients, physicians, and diagnosis outcomes were analysed descriptively through frequency distributions, aggregate analysis, and graphs, while the influence of risk factors on the disease manifestations (diagnosis outcomes) were determined using regression analysis.Results: Findings from our study demonstrated that the difficulty in diagnosing tropical disease was associated with significant increase in morbidity and mortality especially in patients with malaria, UTI and typhoid fever. Factors such as contact with an infected person and poor personal hygiene posed significant risk, while urbanization and homelessness, posed very low risks across all the diseases. Conclusion: The risk factors identified in our study exert differential and discriminating influences in the causation, predisposition, and transmission of these conditions, understanding the individual risk factors for each condition have significant socio-economic implications for people living in tropical and endemic regions, especially with respect to management and prevention of these conditions.

scholarly journals Risk Factors for Soil-Transmitted Helminthiasis in Preschool Children Living in Farmland, North Sumatera, Indonesia

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Sri Novianty ◽  
Yazid Dimyati ◽  
Syahril Pasaribu ◽  
Ayodhia Pitaloka Pasaribu
Keyword(s):  
Risk Factors ◽  
Preschool Children ◽  
Demographic Data ◽  
Significant Risk ◽  
Hand Washing ◽  
World Health ◽  
Life Strategy ◽  
Infection Prevalence ◽  
Cross Sectional ◽  
Soil Transmitted Helminthiasis

Background. Disease burden from soil-transmitted helminthiasis (STH) is mainly attributed to its chronic and insidious impact on health and quality of life. Strategy recommended by World Health Organization (WHO) to control it was previously focused on school-aged children, but now preschool-aged children are involved. This study was intended to determine STH infection risk factors in preschool children.Methods. A cross-sectional study was conducted in Suka Village, North Sumatera, Indonesia, from October to December 2016. Subjects were children aged 1 to 5 years without history of taking antihelminthic. Subjects were obtained by consecutive sampling. Demographic data and risk factors for helminthiasis were collected using questionnaire-based interview. Subjects were divided into two groups, positive and negative STH infection, based on Kato Katz method. Analysis was done using chi-square and logistic regression test.pvalue < 0.05 was considered significant.Results. We enrolled 90 subjects in this study, with the mean age being 31.7 months. STH infection prevalence was 34.4%. Statistical analysis revealed that mother/caregiver hand washing habit (p=0.007), mother/caregiver nail trimming habit (p=0.018), and children nail trimming habit (p=0.022) were significant risk factors for STH infection.Conclusion. Mother/caregiver hand washing habit is the most influential risk factor for STH infection in preschool children.

scholarly journals Risk factors and outcomes for multidrug-resistant Gram-negative bacilli bacteremia

2017 ◽  
Vol 5 (1) ◽  
pp. 11-18 ◽  
Author(s):  
Swati Patolia ◽  
Getahun Abate ◽  
Nirav Patel ◽  
Setu Patolia ◽  
Sharon Frey
Keyword(s):  
Risk Factors ◽  
Urinary Catheter ◽  
Medical Center ◽  
Demographic Data ◽  
Significant Risk ◽  
Antibiotic Use ◽  
Multidrug Resistant ◽  
Solid Organ ◽  
Gram Negative ◽  
Source Of Infection

Background: The incidence of multidrug-resistant (MDR) organisms is increasing along with mortality. Identifying risk factors for the development of MDR Gram-negative bacilli (GNB) bacteremia could greatly impact patient care and management. Methods: Data from the electronic health record of patients with GNB over 13-month period were collected at a single university medical center. Baseline demographic data, risk factor, microbiological data, recurrence of bacteremia, and mortality were recorded. Results: A total of 177 patients were included in the analysis. MDR GNB occurred in 46 patients (26%). The mortality rate in the MDR group was 34.8% compared to 13.7% in non-MDR group ( p = 0.002). In multivariate analysis, diabetes mellitus [DM; odds ratio (OR): 2.8, 95% confidence interval (CI): 1–4.88], previous antibiotic use (OR: 2.93, 95% CI: 1.25–6.87), and urinary catheter as a source of infection (OR 5.96, 95% CI: 1.78–19.94) were significant risk factors for the development of MDR GNB. In addition, end-stage liver disease (OR: 3.64, 95% CI: 1.07–12.3), solid organ malignancy (OR: 3.64, 95% CI: 1.25–10.56), intra-abdominal source of infection (OR: 3.66, 95% CI: 1.14–11.73), inappropriate empiric antibiotics (OR 7.59, 95% CI: 1.68–34.34) and urinary catheter as a source of infection (OR 5.68, 95% CI: 1.37–23.5) were significant factors for mortality in patients with MDR GNB. Conclusion: Our study provides important information about the risk factors for the development of MDR GNB bacteremia and helps prognosticate patient with MDR GNB.

Prevalence and Risk Factors of Monoclonal Proteinemia in Thai Population.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1416-1416
Author(s):  
Phandee Watanaboonyongcharoen ◽  
Thanyaphong Na Nakorn ◽  
Ponlapat Rojnuckarin ◽  
Panisinee Lawasut ◽  
Tanin Intragumtornchai
Keyword(s):  
Risk Factors ◽  
Complete Blood Count ◽  
Conflicts Of Interest ◽  
Demographic Data ◽  
Significant Risk ◽  
Chemical Exposure ◽  
Blood Chemistry ◽  
Serum Samples ◽  
Thai Population ◽  
History Of

Abstract Abstract 1416 Poster Board I-439 Background: Monoclonal gammopathy of undetermined significance (MGUS) is associated with progression to multiple myeloma and related hematologic malignancies at the rate of 1% per year in western population. Reliable information on prevalence, risk factors and natural history of MGUS in general population are necessary for designing an early detection strategy for myeloma in Thailand. Patients and methods: The study was performed in subjects, 50 years of age or older, in Bangkok, one nearby province and 2 remote provinces of Thailand. The demographic data and suspected risk factor history were collected by questionnaires. Complete blood count as well as blood chemistry were done to exclude underlying hematologic and/or systemic conditions. Serum monoclonal proteins were detected using high-resolution gel electrophoresis. Results: Serum samples were obtained from 3,261 participants. There were 1,105 males (33.9%) and 2,156 females (66.1%). The median age was 57. Abnormal protein electrophoresis findings were detected in 76 samples (prevalence 2.3%, 95% confidence interval [CI] 1.8% - 2.8%) showing small M-spikes at gamma-globulin region in 50 (1.5%) or at beta-globulin region in 25 (0.8%) or hypogammaglobulinemia in 1 case (0.03%). The prevalence of MGUS in subjects less than 60, 60-69 and 70 yrs or more was 2.0% (41/1975), 2.6% (22/851) and 3.0% (13/435), respectively. Using multivariate analysis, presence of MGUS was strongly associated with history of drug abuse (odd ratio 4.63, 95%CI 1.14-22.08) and current residences outside Bangkok (odd ratio 2.30, 95%CI 1.18-4.79). Radiation and chemical exposure, hair and nail-coloring products and pesticides were not statistically significant risk factors in our population. Conclusions: The overall prevalence of MGUS in Thai population was 2.3%, lower than those of western countries but comparable to what reported from Japan and Taiwan. Disclosures: No relevant conflicts of interest to declare.

A comparison of exposure to risk factors for giardiasis in non-travellers, domestic travellers and international travellers in a Canadian community, 2006–2012

2015 ◽  
Vol 144 (5) ◽  
pp. 980-999 ◽  
Author(s):  
A. L. SWIRSKI ◽  
D. L. PEARL ◽  
A. S. PEREGRINE ◽  
K. PINTAR
Keyword(s):  
Risk Factors ◽  
Regression Models ◽  
Demographic Data ◽  
International Travel ◽  
Risk Exposure ◽  
Multinomial Regression ◽  
Logistic Regression Models ◽  
Untreated Water ◽  
Promotion Campaigns ◽  
Age And Sex

SUMMARYThe purpose of this study is to determine how demographic and exposure factors related to giardiasis vary between travel and endemic cases. Exposure and demographic data were gathered by public health inspectors from giardiasis cases reported from the Region of Waterloo from 2006 to 2012. Logistic regression models were fit to assess differences in exposure to risk factors for giardiasis between international travel-related cases and Canadian acquired cases while controlling for age and sex. Multinomial regression models were also fit to assess the differences in risk profiles between international and domestic travel-related cases and endemic cases. Travel-related cases (both international and domestic) were more likely to go camping or kayaking, and consume untreated water compared to endemic cases. Domestic travel-related cases were more likely to visit a petting zoo or farm compared to endemic cases, and were more likely to swim in freshwater compared to endemic cases and international travel-related cases. International travellers were more likely to swim in an ocean compared to both domestic travel-related and endemic cases. These findings demonstrate that travel-related and endemic cases have different risk exposure profiles which should be considered for appropriately targeting health promotion campaigns.

scholarly journals Risk Factors Associated With Surgical Site Infection After Pediatric Posterior Spinal Fusion Procedure

2009 ◽  
Vol 30 (2) ◽  
pp. 109-116 ◽  
Author(s):  
W. Matthew Linam ◽  
Peter A. Margolis ◽  
Mary Allen Staat ◽  
Maria T. Britto ◽  
Richard Hornung ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Spinal Fusion ◽  
Univariate Analysis ◽  
Posterior Spinal Fusion ◽  
Site Infection ◽  
Fusion Procedure ◽  
Factors Associated ◽  
Asa Score

Objective.To identify risk factors associated with surgical site infection (SSI) after pediatric posterior spinal fusion procedure by examining characteristics related to the patient, the surgical procedure, and tissue hypoxia.Design.Retrospective case-control study nested in a hospital cohort study.Setting.A 475-bed, tertiary care children's hospital.Methods.All patients who underwent a spinal fusion procedure during the period from January 1995 through December 2006 were included. SSI cases were identified by means of prospective surveillance using National Nosocomial Infection Surveillance system definitions. Forty-four case patients who underwent a posterior spinal fusion procedure and developed an SSI were identified and evaluated. Each case patient was matched (on the basis of date of surgery, ± 3 months) to 3 control patients who underwent a posterior spinal fusion procedure but did not develop an SSI. Risk factors for SSI were evaluated by univariate analysis and multivariable conditional logistic regression. Odds ratios (ORs), with 95% confidence intervals (CIs) andPvalues, were calculated.Results.From 1995 to 2006, the mean annual rate of SSI after posterior spinal fusion procedure was 4.4% (range, 1.1%—6.7%). Significant risk factors associated with SSI in the univariate analysis included the following: a body mass index (BMI) greater than the 95th percentile (OR, 3.5 [95% CI, 1.5–8.3]); antibiotic prophylaxis with clindamycin, compared with other antibiotics (OR, 3.5 [95% CI, 1.2 10.0]); inappropriately low dose of antibiotic (OR, 2.6 [95% CI, 1.0–6.6]); and a longer duration of hypothermia (ie, a core body temperature of less than 35.5°C) during surgery (OR, 0.4 [95% CI, 0.2–0.9]). An American Society of Anesthesiologists (ASA) score of greater than 2, obesity (ie, a BMI greater than the 95th percentile), antibiotic prophylaxis with clindamycin, and hypothermia were statistically significant in the multivariable model.Conclusion.An ASA score greater than 2, obesity, and antibiotic prophylaxis with clindamycin were independent risk factors for SSI. Hypothermia during surgery appears to provide protection against SSI in this patient population.

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