European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
-
Propionibacterium acnes may be considered a new pathogeny for disc degeneration, but its pathological role has remained unclear. This study was designed to determine whether the latent infection of P. acnes was associated with chronic inflammation in degenerated intervertebral discs via quantification of the levels of a series of cytokines and neutrophils. ⋯ Latent P. acnes infection was associated with chronic inflammation in degenerated intervertebral discs, especially in the samples with visible bacteria in histology, which manifested as increased numbers of cytokines and neutrophils. Discs with P. acnes infection had much severer disc degeneration and P. acnes-associated chronic inflammation may be the reason.
-
Multicenter Study
Population-averaged MRI atlases for automated image processing and assessments of lumbar paraspinal muscles.
Growing evidence suggests an association between lumbar paraspinal muscle degeneration and low back pain (LBP). Currently, time-consuming and laborious manual segmentations of paraspinal muscles are commonly performed on magnetic resonance imaging (MRI) axial scans. Automated image analysis algorithms can mitigate these drawbacks, but they often require individual MRIs to be aligned to a standard "reference" atlas. Such atlases are well established in automated neuroimaging analysis. Our aim was to create atlases of similar nature for automated paraspinal muscle measurements. ⋯ We constructed a set of population-averaged atlases for developing automated algorithms to help analyze paraspinal muscle morphometry from axial MRI scans. Such an advancement could greatly benefit the fields of paraspinal muscle and LBP research. These slides can be retrieved under Electronic Supplementary Material.
-
Multicenter Study
The impact of deep surgical site infection on surgical outcomes after posterior adult spinal deformity surgery: a matched control study.
The impact of deep surgical site infection (SSI) on surgical outcomes after adult spinal deformity (ASD) surgery is still unclear. We aimed to study the morbidity of SSI in ASD and its impact on deformity correction and functional outcome. ⋯ SSI significantly affects the first postoperative year after posterior ASD surgery. It is associated with more complications, unrelated revisions, and worst quality of life. However it's negative impact seems to be diluted by the second postoperative year as differences in HRQoL scores between the two groups decrease. These slides can be retrieved under Electronic Supplementary material.
-
The treatment of postoperative deep spinal wound infection involves debridement and intravenous antibiotics. Authors have previously reported success in a small series of patients treated with vacuum-assisted closure (VAC) therapy, but its use over exposed dura is controversial and the outcome has not been reported in large series. ⋯ This is one of the largest studies which confirms the safety and efficacy of VAC dressings in patients with spinal wound infections, even when the dura is exposed. These slides can be retrieved under Electronic Supplementary Material.
-
Multicenter Study
Risk factors for implant removal after spinal surgical site infection.
Few studies have investigated the risk factors for implant removal after treatment for spinal surgical site infection (SSI). Therefore, there is no firmly established consensus for the management of implants. We aimed to investigate the incidence and risk factors for implant removal after SSI managed with instrumentation, and to examine potential strategies for avoiding implant removal. ⋯ Patients with SSI who underwent posterior cervical surgery are likely to retain the implants. Immediate administration of effective antibiotics improves implant survival in SSI treatment. Our findings can be applied to identify SSI patients at higher risk for implant removal.