Adherence and Biofilm Formation of Staphylococcus Epidermidis and Mycobacterium Tuberculosis on Various Spinal Implants

Ha, Kee-Yong; Chung, Yang-Guk; Ryoo, Seung-Joon

doi:10.1097/01.brs.0000147801.63304.8a

Cited by 206 publications

(134 citation statements)

References 26 publications

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“…A 360-degree fusion using an anterior expandable titanium cage led to long-term stability. (Ha et al 2004). Asymptomatic bacterial biofilm on implants has been found even months after successful metal implantation in spinal osteomyelitis (Shad et al 2003).…”

Section: Discussionmentioning

confidence: 99%

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Successful treatment of spondylodiscitis using titanium cages: A 3-year follow-up of 22 consecutive patients

et al. 2008

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Background and purpose The use of metal implants in large defects caused by spinal infection to support the anterior column is controversial, and relatively few results have been published to date. Despite the fact that there is bacterial adhesion to metal implants, the strong immunity of the highly vascularized spine because of rich muscle covering is unique. This possibly allows the use of metal implants, which have the advantage of high stability and reduced loss of correction. This is a retrospective study of patients with spondylodiscitis treated with metal implants.Patients and methods We retrospectively analyzed the outcome in 22 consecutive patients (mean age 69 (43-82) years, 15 men) with spondylodiscitis (20 lumbar and 12 thoracic discs) who had received an anterior titanium cage implantation. In 13 cases, the pathogen could be identified. Antibiotic treatment was continued for at least 12 weeks postoperatively.Results The mean follow-up was 36 (32-47) months. Healing of inflammation was confirmed by clinical, radiographic, and laboratory parameters. The mean VAS improved from 9.1 (6-10) preoperatively to 2.6 (0-6) at the final follow-up, and the mean Oswestry disability index was 17 (0-76) at the final follow-up.Interpretation Our findings highlight the high healing rate and stability when titanium implants are used. Prerequisites are a radical debridement, correction of deformity, and additional bony fusion by bone grafting. The increased stability, with facilitated patient mobilization, and the relatively little loss of correction using anterior and posterior implants are of considerable

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Section: Discussionmentioning

confidence: 99%

“…For decades, the use of metallic implants at an infectious site was avoided because of adhesion of bacteria to the implants (Ha et al 2004). In the spine, the avoidance of internally stabilizing measures may lead to instability, with loss of correction and pseudarthrosis.…”

mentioning

confidence: 99%

Successful treatment of spondylodiscitis using titanium cages: A 3-year follow-up of 22 consecutive patients

et al. 2008

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“…As animal experiments have shown the lower rate of infection with titanium alloy than with stainless steel [2,40], the ideal biocompatibility of titanium may explain the satisfactory results of this series and would partly eliminate the concern of using metallic implants in the setting of infection. However, the results from the studies of relation between material biocompatibility and bacterial or cell adhesion and colonization on the material surface are inconsistent [7,22].…”

Section: Discussionmentioning

confidence: 99%

Anterior instrumentation for the treatment of pyogenic vertebral osteomyelitis of thoracic and lumbar spine

2008

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Anterior radical debridement and bone grafting is popular in the treatment of pyogenic infection of the spine, but there remains great concern of placing instrumentation in the presence of infection because of the potentiality of infection recurrence after surgery. The objective of this study was to prospectively evaluate the efficacy and safety of anterior instrumentation in patients who underwent simultaneous anterior debridement and autogenous bone grafting for the treatment of pyogenic vertebral osteomyelitis. The series consisted of 22 consecutive patients who were treated with anterior debridement, interbody fusion with autogenous bone grafting and anterior instrumentation for pyogenic vertebral osteomyelitis of thoracic and lumbar spine. The patients were prospectively followed up for a minimum of 3 years (average 46.1 months; range 36-74 months). Data were obtained for assessing clinically the neurological function and pain and radiologically the spinal alignment and fusion progress as well as recurrence of the infection. All the patients experienced complete or significant relief of back pain with rapid improvement of neurological function. Kyphosis was improved with an average correction rate of 93.1% (range 84-100%). Solid fusion and healing of the infection was achieved in all the patients without any evidence of recurrent or residual infection. The study shows that combined with perioperative antibiotic regimen, anterior instrumentation is effective and safe in the treatment of pyogenic vertebral osteomyelitis of thoracic and lumbar spine directly following radical debridement and autogenous bone grafting.

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“…Oga et al in 1993 demonstrated that bio-film formation and adherence of mycobacterium tuberculosis to the metallic implants is negligible making them susceptible to host defence mechanism and anti-tuberculous drugs [14]. Their findings removed the phobia of using instrumentation in active spinal tuberculosis [14,15] leading many surgeons to use instrumentation posteriorly in addition to the anterior procedure [16][17][18][19][20] or anteriorly [21][22][23][24] with good results.…”

Section: Surgery In Active Diseasementioning

confidence: 99%

Kyphotic deformity in spinal tuberculosis and its management

Rajasekaran

2012

International Orthopaedics (SICOT)

129

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Spinal tuberculosis is the most common cause of severe kyphosis in many parts of the world. Three percent of patients treated conservatively end up with a deformity greater than 60 degrees which can cause serious cosmetic, psychological, cardio-respiratory and neurological problems. Severe kyphotic deformities are usually the result of childhood spinal deformities and 'Spine at risk' radiological signs are helpful to identify children at risk of deformity. In children, a severe type of collapse, termed as 'Buckling Collapse' is also noted where the kyphosis is more than 120 degrees. Risk factors for buckling collapse include an age of less than seven years at the time of infection, thoracolumbar involvement, loss of more than two vertebral bodies and the presence of radiographic 'Spine-at-risk' signs. In correction of established deformity, posterior only surgery with a variety of osteotomies is now preferred. In patients with deformity of more than 90 degrees, an opening-closing wedge osteotomy must be done to prevent neurological deficit.

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Adherence and Biofilm Formation of Staphylococcus Epidermidis and Mycobacterium Tuberculosis on Various Spinal Implants

Abstract: On the contrary to S. epidermidis, adherence and biofilm formation of M. tuberculosis on implant surface are less likely, and it can provide the basis of successful instrumentation in spine tuberculosis.

Cited by 206 publications

References 26 publications

Successful treatment of spondylodiscitis using titanium cages: A 3-year follow-up of 22 consecutive patients

Successful treatment of spondylodiscitis using titanium cages: A 3-year follow-up of 22 consecutive patients

Anterior instrumentation for the treatment of pyogenic vertebral osteomyelitis of thoracic and lumbar spine

Kyphotic deformity in spinal tuberculosis and its management

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