High Infection Rates in Patients with Long-Segment Dynesys System

Akyoldaş, Göktuğ; Yılmaz, Atilla; Aydın, Ahmet Levent; Öktenoğlu, Tunç; Sasani, Mehdi; Süzer, Tuncer; Akiz, Cenk; Özer, Ali Fahir

doi:10.1016/j.wneu.2018.07.175

Cited by 5 publications

(3 citation statements)

References 14 publications

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“…A literature review on Dynesys system conducted by the National Institute for Clinical Excellence of the National Health Service in the United Kingdom has shown that the Dynesys system can be helpful for patients with intractable lumbar pain 15 . Nevertheless, studies have reported that patients receiving the Dynesys system complain of both back and leg pain, with a relatively high infection rate 16 . A 2-year follow up study reported that Cosmic system can provide safe stabilization and release the pain for the patients with disc herniation 17 .…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Pull‐Out Strength between a Novel Micro‐Dynamic Pedicle Screw and a Traditional Pedicle Screw in Lumbar Spine

Qian

Chen

et al. 2020

Orthopaedic Surgery

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Objective This study aimed to investigate the strength of a novel micro‐dynamic pedicle screw by comparing it to the traditional pedicle screw. Methods Forty‐five lumbar vertebrae received a traditional pedicle screw on one side and a micro‐dynamic pedicle screw on the other side as follows (traditional group vs micro‐dynamic group): 15 vertebrae underwent instant pull‐out testing; 15 vertebrae underwent 5000‐cyclic fatigue loading testing; and 15 vertebrae underwent 10,000‐cyclic fatigue loading testing and micro‐computed tomography (micro‐CT) scanning. The peek pull‐out force and normalized peek pull‐out force after instant pull‐out testing, 5000‐cyclic and 10,000‐cyclic fatigue loading testing were recorded to estimate the resistance of two types of screws. Bone mineral density was recorded to investigate the strength of the different screws in osteoporotic patients. And the semidiameter of the screw insertion area on micro‐CT images after fatigue were compared to describe the performance between screw and bone surface. Results The bone mineral density showed a weak correlation with peek pull‐out force (r = 0.252, P = 0.024). The peek pull‐out force of traditional pedicle screw after 10,000‐cyclic fatigue loading were smaller than that of instant pull‐out test in both osteoporotic (P = 0.017) and healthy group (P = 0.029), the peek pull‐out force of micro‐dynamic pedicle screw after 10,000‐cyclic fatigue loading was smaller than that in instant pull‐out test in osteoporotic group (P = 0.033), but no significant difference in healthy group (P = 0.853). The peek pull‐out force in traditional group and micro‐dynamic group underwent instant pull‐out testing (P = 0.485), and pull‐out testing after 5000‐cyclic fatigue loading testing (P = 0.184) did not show significant difference. However, the peek pull‐out force in micro‐dynamic group underwent pull‐test after 10,000‐cyclic fatigue loading testing was significantly greater than that measured in traditional group (P = 0.005). The normalized peek pull‐out force of traditional groups underwent instant pull‐out testing, pull‐out test after 5000‐cyclic and 10,000‐cyclic fatigue loading testing significantly decreased as the number of cycles increased (P < 0.001); meanwhile, the normalized peek pull‐out force of micro‐dynamic groups remained consistent regardless of the number of cycles (P = 0.133). The semidiameter after the fatigue loading test of the traditional screw insertion area was significantly larger than that of the micro‐dynamic screw insertion area (P = 0.013). Conclusion The novel micro‐dynamic pedicle screw provides stronger fixation stability in high‐cyclic fatigue loading and non‐osteoporotic patients versus the traditional pedicle screw, but similar resistance in low‐cycle fatigue testing and osteoporotic group vs the traditional pedicle screw.

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Section: Introductionmentioning

confidence: 99%

Comparison of the Pull‐Out Strength between a Novel Micro‐Dynamic Pedicle Screw and a Traditional Pedicle Screw in Lumbar Spine

Qian

Chen

et al. 2020

Orthopaedic Surgery

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“…The pathogenesis of purulent spondylitis is mainly hematogenous infection with posterior trauma and local spread [5]. The main pathogenic bacteria of suppurative spondylitis are S. aureus [6] and E. coli [7], while other rare bacteria include Streptococcus, Pneumococcus, Salmonella, Pseudomonas, and Candida [8,9].…”

Section: Discussionmentioning

confidence: 99%

“…Currently, suppurative spondylitis has the following diagnostic criteria: (1) postoperative pathological biopsy; (2) percutaneous puncture biopsy bacterial culture; (3) blood culture (done at least twice); (4) local pain or neurological symptoms; (5) at least one imaging examination (X-ray, CT, MRI, or bone scan); and (6) laboratory tests revealing an acute in ammatory response (CRP > 30 mg/L, ESR > 30 mm/h, T > 38°C).A de nite diagnosis must satisfy both (1) and (2), or (5) and at least one of (1), (2), or (3). The disease can be highly suspected if it satis es both (6) and one of (1), (2), or (5). There is also the possibility of disease detection if ( 4) and one of (3) or (5) coexist.…”

Section: Discussionmentioning

confidence: 99%

The treatment experience of chronic suppurative spondylitis of the thoracolumbar spine

Wang

Deng

et al. 2021

Preprint

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Background This study investigated the diagnostic and therapeutic experience, including conservative, endoscopic and surgical methods, of chronic suppurative spondylitis. Methods A total of 39 patients were included in the imageological, laboratory, and pathological examinations. The patients underwent conservative treatment or operation according to their respective conditions. We used erythrocyte sedimentation rate (ESR) and c-reactive proteins (CRP) to evaluate the state of the illness, visual analogue scales (VAS) to assess lower back and lower limb pain, and the oswestry dysfunction index (ODI) to assess the degree of functional disability. All patients were followed up for 12–36 months. Results Two patients were treated conservatively with antibiotics for 6–8 weeks, while 34 patients underwent different open surgeries, including two cases who underwent second stage surgery. Endoscopic surgery was operated on 3 patients under acute inflammatory stage. All patients' body temperature, VAS score, ESR, and CRP decreased significantly (P < 0.05). Imaging showed that lesions were stationary and that bone fusion occurred 8–14 months after surgery, with an average of 10.00 ± 0.92 months. Conclusions Clinicians should acquire a detailed medical history and evaluate the laboratory and imaging results comprehensively to select an appropriate treatment plan. Treatment, including the choosing of an adequate surgical method, should be based on the purpose of the operation and the patient's general condition.

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