scholarly journals Debridement and corpectomy via single posterior approach to treat pyogenic spondylitis after vertebral augmentation

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Shuai Zhang ◽  
Song Wang ◽  
Qing Wang ◽  
Jin Yang ◽  
Shuang Xu
Keyword(s):  
Severe Pain ◽  
Neurological Deficits ◽  
Spinal Stability ◽  
Vertebral Augmentation ◽  
Pathogenic Microorganisms ◽  
Surgical Time ◽  
Pyogenic Spondylitis ◽  
Single Posterior Approach ◽  
Posterior Debridement ◽  
Effective Treatments

Abstract Background Infection after vertebral augmentation (VA) often limits the daily activities of patients and even threatens their life. The operation may be one of the effective treatments if the patient suffers from intolerable severe pain, neurological deficits, and damage to spinal stability. This study aimed to investigate the clinical efficacy of the treatment of pyogenic spondylitis after vertebral augmentation (PSVA) with Single posterior debridement, vertebral body resection, and intervertebral bone graft fusion and internal fixation (sPVRIF). Methods The study was performed on 19 patients with PSVA who underwent VA at 4 hospitals in the region between January 2010 and July 2020. Nineteen patients were included. Among them, 16 patients underwent sPVRIF to treat the PSVA. Results A total of 2267 patients underwent VA at 4 hospitals in the region. Of the 19 patients with postoperative PSVA, suppurative spondylitis was misdiagnosed as an osteoporotic vertebral fracture(OVF) in 4 patients and they underwent VA. Besides osteoporosis, 18 patients had other comorbidities. The average interval between the first surgery and the diagnosis of PSVA was 96.4 days. Of the 19 patients, 16 received surgical treatment. The surgical time was 175.0±16.8 min, and the intraoperative blood loss was 465.6±166.0 mL. Pathogenic microorganisms were cultured in 12 patients. Conclusion PSVA is a severe complication that can even threaten the life of the patients. sPVRIF may be one of the effective treatments if the patient suffers from intolerable severe pain, neurological deficits, and damage to spinal stability.

Debridement and Corpectomy Via Single Posterior Approach to Treat Pyogenic Spondylitis after Vertebral Augmentation

2021 ◽  
Author(s):  
Shuai Zhang ◽  
Song Wang ◽  
Qing Wang ◽  
Jin Yang ◽  
Shuang Xu
Keyword(s):  
Severe Pain ◽  
Daily Activities ◽  
Neurological Deficits ◽  
Spinal Stability ◽  
Intraoperative Blood Loss ◽  
Surgical Time ◽  
Refractory Septic Shock ◽  
Single Posterior Approach ◽  
Efficacy Of Treatment ◽  
Effective Treatments

Abstract Background Infection after VA often limits the daily activities of patients and even threatens their life. Operation has become an indispensable choice for such patients. sPVRIF may be one of the effective treatments if the patient suffers from intolerable severe pain, neurological deficits, and damage to spinal stability. This study aimed to investigate the clinical efficacy of treatment of PSVA with sPVRIF. Methods The study was performed on 19 patients with PSVA who underwent VA at 4 hospitals in the region between January 2010 and July 2020. Nineteen patients were included. Among them, 16 patients underwent sPVRIF to treat the PSVA.Results A total of 2267 patients underwent VA at 4 hospitals in the region. Of the 19 patients with postoperative PSVA, suppurative spondylitis was misdiagnosed as an osteoporotic vertebral fracture in 4 patients and they underwent VA. Besides osteoporosis, 18 patients had other comorbidities.The average interval between the first surgery and the diagnosis of PSVA was 96.4 days. Of the 19 patients, 16 received surgical treatment.Among the patients undergoing surgery, one died of refractory septic shock after the surgery, and one died of prostate cancer. The surgical time was 175.0±16.8min, and the intraoperative blood loss was 465.6±166.0 mL.Fourteen patients recovered from the infection.Pathogenic microorganisms were cultured in 12 patients. Conclusion PSVA is an extremely serious complication that can even threaten the life of the patients.sPVRIF may be one of the effective treatments if the patient suffers from intolerable severe pain, neurological deficits, and damage to spinal stability.

scholarly journals Advances in Vertebral Augmentation Systems for Osteoporotic Vertebral Compression Fractures

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Yufeng Long ◽  
Weihong Yi ◽  
Dazhi Yang
Keyword(s):  
Elderly Population ◽  
Vertebral Compression Fracture ◽  
Compression Fracture ◽  
The Elderly ◽  
Cement Leakage ◽  
Clinical Results ◽  
Vertebral Compression Fractures ◽  
Vertebral Augmentation ◽  
Surgical Time ◽  
Cause Of Pain

Osteoporotic vertebral compression fracture (OVCF) is a common cause of pain and disability and is steadily increasing due to the growth of the elderly population. To date, percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) are almost universally accepted as appropriate vertebral augmentation procedures for OVCFs. There are many advantages of vertebral augmentation, such as short surgical time, performance under local anaesthesia, and rapid pain relief. However, there are certain issues regarding the utilization of these vertebral augmentations, such as loss of vertebral height, cement leakage, and adjacent vertebral refracture. Hence, the treatment for OVCF has changed in recent years. Satisfactory clinical results have been obtained worldwide after application of the OsseoFix System, the SpineJack System, radiofrequency kyphoplasty of the vertebral body, and the Kiva VCF treatment system. The following review discusses the development of the current techniques used for vertebral augmentation.

scholarly journals The efficacy of single posterior debridement, bone grafting, and instrumentation for the treatment of thoracic spinal tuberculosis

2020 ◽  
Author(s):  
Jiao Zhou ◽  
Quanyi Li ◽  
Yongchun Zhou ◽  
Qichun Song
Keyword(s):  
Bone Grafting ◽  
Spinal Tuberculosis ◽  
Clinical Manifestations ◽  
Adult Patients ◽  
Thoracic Spinal ◽  
Imaging Results ◽  
Single Posterior Approach ◽  
Posterior Debridement ◽  
Thoracic Spinal Tuberculosis

Abstract Background: The aim of this study was to investigate the clinical efficacy of single posterior debridement, bone grafting, and instrumentation for the treatment of thoracic spinal tuberculosis of adult patients. Methods: A retrospective analysis was conducted on 88 adult patients with thoracic spinal tuberculosis between June 2013 and September 2017. All patients were treated with single posterior debridement, bone grafting and instrumentation. The clinical manifestations and laboratory and imaging results of the approach were subsequently analysed. Results: All patients were followed up for 40.6 ± 4.1 m (range, 36–48 m). Bony fusion was achieved in all bone grafts. The VAS scores, ESR, and CRP levels 6 weeks after operation and at the final follow-up were significantly lower than the preoperative levels (P<0.05). The postoperative and final-follow-up kyphosis angles were both significantly smaller than the pre-operative kyphosis angles (P<0.05). The postoperative angle correction rate reached 81.5%, and the postoperative angle loss only reached 4.1%. At the last follow-up, ASIA improvement was significant compared with the preoperative levels (P<0.05). Conclusion: The single posterior approach can achieve satisfactory clinical outcomes in the treatment of thoracic spinal tuberculosis.

SIGNIFICANCE AND NEED OF TREATMENT OF PERIAPICAL LESION

INDIAN DRUGS ◽  
2014 ◽  
Vol 51 (07) ◽  
pp. 5-13
Author(s):  
S.R Pattan ◽  
◽  
P.S Bykod ◽  
P.U. Shetkar ◽  
S.V. Pattewar ◽  
...  
Keyword(s):  
Dental Caries ◽  
Infectious Diseases ◽  
Dental Pulp ◽  
Severe Pain ◽  
Tooth Loss ◽  
The Body ◽  
Periapical Lesion ◽  
Endodontic Disease ◽  
Periapical Inflammation ◽  
Effective Treatments

Dental caries, one of the most prevalent infectious diseases worldwide, affects approximately 80% of children and the majority of adults. Dental caries may result in endodontic disease, leading to dental pulp necrosis, periapical inflammation and bone desorption, severe pain, and tooth loss. Periapical inflammation may also increase inflammation in other parts of the body. Although many studies have attempted to develop therapies for this disease, there is still an urgent need for effective treatments.

Antibiotic–polymethylmethacrylate strut: an option for treating cervical pyogenic spondylitis

2006 ◽  
Vol 5 (1) ◽  
pp. 90-95 ◽  
Author(s):  
Jyi-Feng Chen ◽  
Shih-Tseng Lee
Keyword(s):  
Neurological Deficits ◽  
Local Drug Delivery ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Pyogenic Spondylitis ◽  
Spine Stabilization ◽  
Spinal Reconstruction ◽  
Effective System ◽  
Vancomycin Powder ◽  
Antibiotic Agents

✓ Antibiotic–polymethylmethacrylate (PMMA) cement and beads constitute an effective system of local drug delivery of antibiotic agents in patients with bone and soft-tissue infections. Debridement followed by implantation of antibiotic–PMMA beads and systemic administration of antibiotic agents has achieved a 100% success rate in treating chronic osteomyelitis; however, there have been no reports of an antibiotic–PMMA strut for treating spinal pyogenic spondylitis. In this case report we describe a 57-year-old woman with C5–6 pyogenic spondylitis, progressive kyphotic deformity, and neurological deficits. The patient underwent anterior C-5 and C-6 corpectomy and spinal reconstruction in which we used an antibiotic–PMMA strut. The strut was 14 mm in diameter and contained PMMA and vancomycin powder. The operation was technically successful, and no complication related to anesthesia or the surgical procedure occurred. At the 12-month follow-up examination, dynamic radiographs revealed cervical spine stabilization. The patient’s neck pain subsided and she recovered neurologically with no residual infection. No antibiotic–PMMA strut dislodgment or failure was identified; however, 9.8% subsidence of the strut into the vertebrae was observed. The long-term outcome in this case requires further evaluation.

Thoracic and lumbar tuberculous spondylitis treated by posterior debridement, graft placement, and instrumentation: a retrospective analysis in 19 cases

2005 ◽  
Vol 3 (6) ◽  
pp. 450-458 ◽  
Author(s):  
Feyza Karagöz Güzey ◽  
Erhan Emel ◽  
N. Serdar Bas ◽  
Selim Hacisalihoglu ◽  
Hakan Seyithanoglu ◽  
...  
Keyword(s):  
Spinal Injury ◽  
Posterior Instrumentation ◽  
Neurological Deficits ◽  
Easy Access ◽  
Tuberculous Spondylitis ◽  
Content Type ◽  
The Mean ◽  
Posterior Debridement ◽  
Fine Print

Object. Surgical treatment of thoracic and lumbar tuberculous spondylitis is controversial. An anterior approach is usually recommended. The aim of the present study was to assess the efficacy of posterior debridement and the placement of posterior instrumentation for the treatment of patients with thoracic and lumbar tuberculous spondylitis. Methods. Nineteen patients with thoracic and lumbar tuberculous spondylitis underwent single-stage posterior decompression and debridement as well as the placement of posterior interbody grafts if necessary, instrumentation and posterior or posterolateral grafts. No postoperative neurological deterioration was noted. One patient died of myocardial infarction on Day 10. The mean follow-up duration, excluding the one death, was 52.7 months (range 16–125 months). In a 70-year-old patient, a single pedicle screw broke after 3 months. All patients were in better neurological condition after surgery and at the last follow-up examination. Neurological deficits were present in only two patients at the last follow up (one American Spinal Injury Association Grade B and one Grade C deficit preoperatively). Three other patients suffered intermittent back or low-back pain. The mean angulation measured in 13 patients with kyphotic deformity was 18.2° (range 5–42°) preoperatively; this was reduced to 17.3° (range 0–42°) after surgery. There was a 2.8° loss of correction (range 2–5°) after 44.3 months (16–64 months). Kyphosis did not progress beyond 15 months in any patient. Conclusions A posterior approach in combination with internal fixation and posterior or posterolateral fusion (with or without placement of posterior interbody grafts) may be sufficient for the debridement of the infection and to allow spinal stabilization in patients with thoracic and lumbar tuberculous spondylitis. This procedure is associated with easy access to the spinal canal for neural decompression, prevention of loss of corrected vertebral alignment in the long term, and facilitation of early mobilization.

Extradural cyst causing spinal cord compression in osteoporotic compression fracture

2013 ◽  
Vol 19 (1) ◽  
pp. 133-137 ◽  
Author(s):  
Jung-Hee Lee ◽  
Ki-Tack Kim ◽  
Kyung-Soo Suk ◽  
Sang-Hun Lee ◽  
Bi-O Jeong ◽  
...  
Keyword(s):  
Compression Fracture ◽  
Cord Compression ◽  
Neurological Deficits ◽  
Mr Images ◽  
Osteoporotic Compression Fracture ◽  
Progressive Neurological Deficit ◽  
History Of ◽  
Extradural Cyst ◽  
Single Posterior Approach ◽  
Epidural Cyst

Intraspinal cystic lesions with different pathogeneses have been reported to cause neurological deficits; however, no one has focused on the intraspinal extradural cysts that develop after osteoporotic compression fracture. The reported case features a 66-year-old woman presenting with progressive neurological deficit, back pain, and no history of additional trauma after undergoing conservative treatment for an osteoporotic fracture of L-1. The authors present serial radiographs and MR images demonstrating an epidural cyst successfully treated via a single posterior approach. This appears to be the first such case reported in the literature.

scholarly journals Outcomes of Surgical Decompression for Spinal Metastases From Gynecological Cancers: A Retrospective Cohort Study

2021 ◽  
Vol 7 (1) ◽  
pp. 37-48
Author(s):  
Luiz Alves Vieira Netto ◽  
◽  
Luís Felipe Araújo Peres ◽  
Nayara Matos Pereira ◽  
Alice Jardim Zaccariotti1 ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Overall Survival ◽  
Spinal Injury ◽  
Spinal Metastasis ◽  
Gynecological Cancer ◽  
Spinal Metastases ◽  
Decompressive Surgery ◽  
Neurological Deficits ◽  
Spinal Instability ◽  
Spinal Stability

Background and Aim: Gynecological cancer is one of the most common types of cancer worldwide. Nonetheless, spinal metastasis from gynecological cancer is scarcely reported in the literature. In cases of spinal cord compression, the standard treatment is a decompressive surgery followed by radiotherapy treatment for selected patients. This study aimed to report the overall survival and surgical results in patients presenting with gynecological spinal metastases who underwent spinal cord/nerve root decompression and stabilization. Methods and Materials/Patients: A total of 18 patients were included in this study. The surgical procedures were performed from 2012 to 2019. The evaluation of neurological status, spinal stability, and pain were performed using the American Spinal Injury Association Impairment Scale (ASIA), Spinal Instability Neoplastic Score (SINS), and Visual Analogue Scale (VAS), respectively. Results: The lumbar spine was the most affected location (n=30; 50.0%). Regarding the preoperative neurological deficits, 16 cases (n=16; 88.9%) presented ASIA graded A–D before the surgery, being reduced to five (n=5; 27.8%) after the procedures. The pain level means (pre-and postoperative) were 9.39±0.79 and 2.28±1.44. The overall median survival was 6.1 months (95% Confidence Interval [CI] of 1.10–11.13 months). The mean survival of ambulatory and non-ambulatory patients before the surgery was 7.36 months and 3.2 months, respectively (P=0.007 – Log-rank Mantel–Cox). Conclusion: Decompressive surgery and stabilization promote mechanical pain relief, spinal stability, an improvement of neurological function, and indirectly improving quality of life, despite a dismal overall survival of patients who present with metastatic spinal compression disease.

Osteoradionecrosis of the cervical spine resulting from radiotherapy for primary head and neck malignancies: operative and nonoperative management

2005 ◽  
Vol 3 (2) ◽  
pp. 159-164 ◽  
Author(s):  
Daniel J. Donovan ◽  
Thanh V. Huynh ◽  
Eric B. Purdom ◽  
Robert E. Johnson ◽  
Joseph C. Sniezek
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Head And Neck ◽  
Hyperbaric Oxygen ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Neurological Deficits ◽  
Spinal Instability ◽  
Spinal Stability ◽  
Head And Neck Malignancies

✓ Osteoradionecrosis is a process of dysvascular bone necrosis and fibrous replacement following exposure to high doses of radiation. The poorly vascularized necrotic tissue may cause pain and/or instability, and it cannot resist infection well, which may result in secondary osteomyelitis. When these processes affect the cervical spine, the resulting instability and neurological deficits can be devastating, and immediate reestablishment of spinal stability is paramount. Reconstruction of the cervical spine can be particularly challenging in this subgroup of patients in whom the spine is poorly vascularized after radical surgery, high-dose irradiation, and infection. The authors report three cases of cervical spine osteoradionecrosis following radiotherapy for primary head and neck malignancies. Two patients suffered secondary osteomyelitis, severe spinal deformity, and spinal cord compression. These patients underwent surgery in which a vascularized fibular graft and instrumentation were used to reconstruct the cervical spine; subsequently hyperbaric oxygen (HBO) therapy was instituted. Fusion occurred, spinal stability was restored, and neurological dysfunction resolved at the 2- and 4-year follow-up examinations, respectively. The third patient experienced pain and dysphagia but did not have osteomyelitis, spinal instability, or neurological deficits. He underwent HBO therapy alone, with improved symptoms and imaging findings. Hyperbaric oxygen is an essential part of treatment for osteoradionecrosis and may be sufficient by itself for uncomplicated cases, but surgery is required for patients with spinal instability, spinal cord compression, and/or infection. A vascularized fibular bone graft is a very helpful adjunct in these patients because it adds little morbidity and may increase the rate of spinal fusion.

β-Mannosidosis: Myelin and oligodendrocyte lesions in brain and spinal cord

1984 ◽  
Vol 42 ◽  
pp. 694-695
Author(s):  
Kathryn L. Lovell ◽  
Margaret Z. Jones
Keyword(s):  
Spinal Cord ◽  
Nervous System ◽  
Genetic Disorder ◽  
Neurological Deficits ◽  
Axonal Spheroids ◽  
South Wales ◽  
Pendular Nystagmus ◽  
Myelin Deficits ◽  
Recessive Defect ◽  
Brain And Spinal Cord

Caprine β-mannosidosis, an autosomal recessive defect of glycoprotein catabolism, is associated with a deficiency of tissue and plasma -mannosidase and with tissue accumulation and urinary excretion of oligosaccharides, including the trisaccharide Man(β1-4)GlcNAc(βl-4)GlcNAc and the disaccharide Man(β1-4)GlcNAc. This genetic disorder is evident at birth, with severe neurological deficits including a marked intention tremor, pendular nystagmus, ataxia and inability to stand. Major pathological characteristics described in Nubian goats in Michigan and in Anglo-Nubian goats in New South Wales include widespread cytoplasmic vacuolation in the nervous system and viscera, axonal spheroids, and severe myelin paucity in the brain but not spinal cord or peripheral nerves. Light microscopic examination revealed marked regional variation in the severity of central nervous system myelin deficits, with some brain areas showing nearly complete absence of myelin and other regions characterized by the presence of 25-50% of the control number of myelin sheaths.

Sign in / Sign up

Export Citation Format

Share Document