A case of postoperative tubercular spondylitis following microdiscectomy for lumbar disc herniation

Background: Postoperative infections are one of the most common complications of spine surgery. However, following a lumbar microdiscectomy, a postoperative infection involving Mycobacterium tuberculosis (MTB) is extremely rare. Case Description: One and half months after a L4-5 microdiscectomy, a 47-year-old immunocompromised male with hepatitis B infection presented with low back and bilateral gluteal pain. The MRI revealed a large intraspinal/paraspinal fluid collection spanning from L4 to S1 along with an anterior epidural collection at L5. The patient underwent a L4 lumbar laminectomy for abscess drainage and wound debridement. After obtaining a positive culture for MTB, four antitubercular drug therapies (ATTs) were started, that is, isoniazid (H), rifampicin (R), ethambutol (E), a. One month later, the patient had minimal pain and no residual neurological deficit. Conclusion: MTB infection, although rare, should be considered among the differential diagnoses of postoperative infections following lumbar spine surgery in immunocompromised patients living in areas where tuberculosis is endemic.

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77. The incidence of subsequent lumbar spine surgery after lumbar disc arthroplasty: a minimum two-year follow-up

The Spine Journal ◽

10.1016/j.spinee.2020.05.180 ◽

2020 ◽

Vol 20 (9) ◽

pp. S37-S38

Author(s):

Dean C. Perfetti ◽

Austen Katz ◽

Alan Job ◽

Jesse M. Galina ◽

Alexander M. Satin ◽

...

Keyword(s):

Lumbar Spine ◽

Spine Surgery ◽

Lumbar Disc ◽

Lumbar Spine Surgery ◽

Disc Arthroplasty ◽

Lumbar Disc Arthroplasty

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P88 Identifying risk factors for multiple revisional lumbar spine surgery

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2019-abn.145 ◽

2019 ◽

Vol 90 (3) ◽

pp. e45.1-e45

Author(s):

M El Sheikh ◽

K Badran ◽

O Kouli ◽

M Abdelsadg ◽

M Fadelalla ◽

...

Keyword(s):

Risk Factors ◽

Lumbar Spine ◽

Spine Surgery ◽

Disc Herniation ◽

Lumbar Disc ◽

Morbidity Rate ◽

Lumbar Spine Surgery ◽

Neurosurgical Department ◽

Primary Surgery ◽

Diabetes Status

ObjectivesRecurrent lumbar spine surgery due to disc herniation is a contributor to debilitating pain, disability, and carries a high patient morbidity rate1 We identified risk factors for recurrent lumbar disc herniation post-surgical intervention.DesignRetrospective Cohort Study.SubjectsAll adult lumbar spine revisions for disc herniation performed in the Neurosurgical Department at Ninewells Hospital.MethodsThe number of revisions from 2013 to 2017 for each patient was recorded and two groups were identified. The first group consisted of patients who had one revision and the second group consisted of patients who had recurrent revisions (more than one) Possible factors influencing the likelihood of recurrent revisions were also noted, including age, gender, BMI, operation length, level of surgery, time from primary surgery to revision, smoking and diabetes status.Results140 patients had revision surgeries, of which 87 (62.1%) had one revision while 53 (37.1%) had recurrent operations. Younger patients (p=0.025) and patients with higher BMI (p=0.01) were more likely to have a higher number of revisions. Patients with DM (p=0.015) were associated with a higher likelihood of recurrent revisions. Other factors had little effect on the likelihood of recurrent revisions (p>0.05).ConclusionsIdentifying risk factors that influence the recurrence of lumbar revisions helps improve patient outcome and decrease incidence of revisions.

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A Variable-angled Suction Nerve Root Retractor for Lumbar Spine Surgery

Neurosurgery ◽

10.1227/00006123-199109000-00014 ◽

1991 ◽

Vol 29 (3) ◽

pp. 419-420

Author(s):

Michael H. Lavyne

Keyword(s):

Lumbar Spine ◽

Spine Surgery ◽

Nerve Root ◽

Lumbar Disc ◽

Lumbar Disc Surgery ◽

Lumbar Spine Surgery ◽

Disc Surgery

Abstract A simple, variable-angled suction nerve root retractor is described for use primarilv in lumbar disc surgery.

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Low Back Pain Versus Back-Related Leg Pain: How Do Patient Expectations and Outcomes of Lumbar Spine Surgery Compare?

HSS Journal ® ◽

10.1177/15563316211010489 ◽

2021 ◽

pp. 155633162110104

Author(s):

Christopher M. Brusalis ◽

Roland Duculan ◽

Frank P. Cammisa ◽

Andrew A. Sama ◽

Alexander P. Hughes ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Lumbar Spine ◽

Spine Surgery ◽

Patient Expectations ◽

Leg Pain ◽

Pain Patient ◽

Lumbar Spine Surgery ◽

Low Back ◽

Preoperative Expectations

Background: An increasing number of lumbar spine conditions are treated surgically. Such intervention, however, is commonly thought to be more effective in addressing leg pain than low back pain. Patient expectations may also contribute to self-reported surgical outcomes. Questions/Purposes: We sought to compare the expectations of patients in 2 groups undergoing lumbar spine surgery: those with predominantly low back pain and those with predominantly leg pain. We also sought to evaluate how these expectations were fulfilled for each group. Methods: We carried out a retrospective analysis of prospectively collected data from a prior study in which patients scheduled for lumbar spine surgery at a single institution completed validated surveys preoperatively and at 2 years postoperatively, including a 20-item survey on expectations for lumbar spine surgery. The patients were enrolled in the study between February 2010 and August 2012, and were divided into 2 cohorts: a “Back > Leg” group that consisted of patients with back pain that was isolated or greater than leg pain, and a “Leg ≥ Back” group that consisted of patients with leg pain that equaled or exceeded back pain. The primary analysis compared composite expectation scores (range, 0–100) between groups. Results: A total of 366 patients were deemed eligible for the study; of these, 162 patients were allocated to the Back > Leg group and 204 patients were allocated to the Leg ≥ Back group. Patients in the Leg ≥ Back group had a greater mean preoperative expectation score compared with those in the Back > Leg group. Multivariate analysis demonstrated that higher preoperative expectations were associated with leg pain symptoms after controlling for disease diagnosis. Both groups reported similar proportions of fulfilled expectations. Conclusion: Patients with predominantly leg pain hold greater preoperative expectations for lumbar spine surgery than do patients with predominantly back pain. That these patient groups reported similar fulfillment of their expectations at 2 years postoperatively illustrates the greater clinical outcomes achieved among patients who presented with predominantly leg pain.

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A Comparison of Isolated Lumbar Extension Strength Between Healthy Asymptomatic Participants and Chronic Low Back Pain Participants Without Previous Lumbar Spine Surgery

Spine ◽

10.1097/brs.0000000000002701 ◽

2018 ◽

Vol 43 (20) ◽

pp. E1232-E1237 ◽

Cited By ~ 1

Author(s):

Rebecca Conway ◽

Jessica Behennah ◽

James Fisher ◽

Neil Osborne ◽

James Steele

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Lumbar Spine ◽

Spine Surgery ◽

Chronic Low Back Pain ◽

Lumbar Spine Surgery ◽

Low Back ◽

Lumbar Extension

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Fear of Movement Is Related to Low Back Disability During a Two-Year Period in Patients Who Have Undergone Elective Lumbar Spine Surgery

World Neurosurgery ◽

10.1016/j.wneu.2020.01.218 ◽

2020 ◽

Vol 137 ◽

pp. e416-e424

Author(s):

Mike K. Kemani ◽

Olle Hägg ◽

Max Jakobsson ◽

Mari Lundberg

Keyword(s):

Lumbar Spine ◽

Spine Surgery ◽

Lumbar Spine Surgery ◽

Low Back ◽

Fear Of Movement

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Allogeneic blood transfusions and postoperative infections after lumbar spine surgery

The Spine Journal ◽

10.1016/j.spinee.2015.02.010 ◽

2015 ◽

Vol 15 (5) ◽

pp. 901-909 ◽

Cited By ~ 41

Author(s):

Stein J. Janssen ◽

Yvonne Braun ◽

Kirkham B. Wood ◽

Thomas D. Cha ◽

Joseph H. Schwab

Keyword(s):

Lumbar Spine ◽

Spine Surgery ◽

Allogeneic Blood ◽

Lumbar Spine Surgery ◽

Blood Transfusions ◽

Postoperative Infections

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Incidence & Management of Delayed Cerebrospinal Fluid Leaks after Lumbar Spinal Surgery-Analysis of 10 Cases

Pakistan Journal Of Neurological Surgery ◽

10.36552/pjns.v23i3.363 ◽

2019 ◽

Vol 23 (3) ◽

pp. 221-227

Author(s):

MUHAMMAD MUKHTAR KHAN ◽

FAIQAFILZA KHAN ◽

WASEEM DAD KHAN

Keyword(s):

Cerebrospinal Fluid ◽

Lumbar Spine ◽

Spine Surgery ◽

Lumbar Disc ◽

Bed Rest ◽

Csf Leak ◽

Lumbar Spine Surgery ◽

Dural Defect ◽

Degenerative Lumbar Spine ◽

Csf Leaks

Objectives: Cerebrospinal fluid (CSF) leaks in degenerative lumbar spine surgery are common, however, delayed cerebrospinal fluid (CSF) leaks are quite rare in neurosurgical practice. Literature regarding its incidence and management is scant.Our aim was to describe the incidence & management of delayed CSF leaks after degenerative lumbar spine surgery. Material & Methods: This was a prospective study where all patients operated for lumbar disc or stenosis, who presented with the delayed CSF leak (> 1 week postoperatively) without intraoperative record of incidental durotomy were included. Data was collected about demographics, diagnosis, operative detail, postoperative course & management issues. Results: Ten out of 1128 patients developed delayed CSF leaks (0.89%). Mean age at the time of diagnosis was 52.1 ± 6.9 years with 6 (60%) males & 4 (40%) female. The most common spinal level was L5-S1 (50%). Eighty percent (n = 8) patients underwent primary surgery while 20% (n = 2) were revisions. Clinical features were headaches (80%), dizziness (70%) and altered sensorium in 20%. Mean time of the leak was 17.3 ± 2.2 days. Two patients resolved with bed rest and compression dressing while the lumbar drain was placed in 80%. Three (30%) patients of the 8 needed open repair of the dural defect. Complications of the CSF leak included wound infection in 60%, and meningitis in one (10%) patient. There were no cases of neurologic deficit. One case eventually developed infective discitis.

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