Minimally invasive spine surgery as treatment for persistent infectious lumbar spondylodiscitis: a systematic review and meta-analysis

Slowinski, Joshua; Lucasti, Christopher; Maraschiello, Mark; Kluczynski, Melissa A.; Kowalski, Joseph T.; Hamill, Christopher L.

doi:10.21037/jss-21-50

Cited by 4 publications

(7 citation statements)

References 16 publications

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“…While both are surgical approaches, the techniques are inherently different and can have varying associated consequences and outcomes. Therefore, the outcomes can also be different, as MIS has been well associated with lower infection rates compared to open surgery [10, 39]. These findings were also replicated in the current study [14, 16, 30].…”

Section: Discussionsupporting

confidence: 78%

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Lower re-rupture rates but higher complication rates following surgical versus conservative treatment of acute achilles tendon ruptures: a systematic review of overlapping meta-analyses

Seow

Islam

Randall

et al. 2023

Knee Surg Sports Traumatol Arthrosc

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Purpose To systematically review and evaluate the current meta-analyses for the treatment of acute Achilles tendon rupture (AATR). This study can provide clinicians with a clear overview of the current literature to aid clinical decision-making and the optimal formulation of treatment plans for AATR. Methods Two independent reviewers searched PubMed and Embase on June 2, 2022 based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Assessment of evidence was twofold: level of evidence (LoE) and quality of evidence (QoE). LoE was evaluated using published criteria by The Journal of Bone and Joint Surgery and the QoE by the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) scale. Pooled complication rates were highlighted for signiicance in favour of one treatment arm or no signiicance. Results There were 34 meta-analyses that met the eligibility criteria, with 28 studies of LoE 1, and the mean QoE was 9.8 ± 1.2. Signiicantly lower re-rupture rates were reported with surgical (2.3-5%) versus conservative treatment (3.9-13%), but conservative treatment was favoured in terms of lower complication rates. The re-rupture rates were not signiicantly diferent between percutaneous repair or minimally invasive surgery (MIS) compared to open repair, but MIS was favoured in terms of lower complication rates (7.5-10.4%). When comparing rehabilitation protocols following open repair (four studies), conservative treatment (nine studies), or combined (three studies), there was no signiicant diference in terms of re-rupture or obvious advantage in terms of lower complication rates between early versus later rehabilitation. Conclusion This systematic review found that surgical treatment was signiicantly favoured over conservative treatment for re-rupture, but conservative treatment had lower complication rates other than re-rupture, notably for infections and sural nerve injury. Open repair had similar re-rupture rates to MIS, but lower complication rates; however, the rate of sural nerve injuries was lower in open repair. When comparing earlier versus later rehabilitation, there was no diference in re-rupture rates or obvious advantage in complications between open repair, conservative treatment, or when combined. The indings of this study will allow clinicians to efectively counsel their patients on the postoperative outcomes and complications associated with diferent treatment approaches for AATR. Level of evidence IV.

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Section: Discussionsupporting

confidence: 78%

“…However, some of the meta-analyses did signiicantly favour open repair to reduce sural nerve injury. The challenge in interpreting many of the current meta-analyses is that when comparing surgical [10,39]. These indings were also replicated in the current study [14,16,30].…”

Section: Discussionsupporting

confidence: 63%

Lower re-rupture rates but higher complication rates following surgical versus conservative treatment of acute achilles tendon ruptures: a systematic review of overlapping meta-analyses

Seow

Islam

Randall

et al. 2023

Knee Surg Sports Traumatol Arthrosc

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“…Lumbar spinal fusion is primarily performed to address various conditions such as spondylolisthesis, scoliosis, lumbar stenosis, trauma, as well as oncological and infectious disorders [ 3 - 5 ]. The most prevalent fixation strategy for achieving stability in spinal segments and facilitating solid fusion is the placement of transpedicular screws.…”

Section: Introductionmentioning

confidence: 99%

Intraoperative Cone-Beam Computed Tomography Navigation Versus 2-Dimensional Fluoroscopy in Single-Level Lumbar Spinal Fusion: A Comparative Analysis

Vadalà,

Papalia,

Russo

et al. 2024

Neurospine

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Objective: Several studies have advocated for the higher accuracy of transpedicular screw placement under cone-beam computed tomography (CBCT) compared to conventional 2-dimensional (2D) fluoroscopy. The superiority of navigation systems in perioperative and postoperative outcomes remains a topic of debate. This study aimed to compare operative time, screw placement time and accuracy, total radiation dose, perioperative and postoperative outcomes in patients who underwent transpedicular screw fixation for degenerative lumbar spondylolisthesis (DLS) using intraoperative CBCT navigation versus 2D fluoroscopy.Methods: A retrospective analysis was conducted on patients affected by single-level DLS who underwent posterior lumbar instrumentation with transpedicular screw fixation using surgical CBCT navigation (NV group) or 2D fluoroscopy-assisted freehand technique (FH group). Demographics, screw placement time and accuracy, operative time, total radiation dose, intraoperative blood loss, screw revision rate, complications, and length of stay (LOS) were assessed.Results: The study included a total of 30 patients (NV group: n = 15; FH group: n = 15). The mean screw placement time, operative time, and LOS were significantly reduced in the NV group compared to the FH group (p < 0.05). The total radiation dose was significantly higher in the NV group (p < 0.0001). No significant difference was found in terms of blood loss and postoperative complications.Conclusion: This study suggests that intraoperative CBCT-navigated single-level lumbar transpedicular screw fixation is superior in terms of mean screw placement time, operative time, and LOS compared to 2D fluoroscopy, despite a higher intraoperative radiation exposure.

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“…Paravertebral abscesses and spinal empyema might result in different clinical symptoms. Intravenous drug use, severe concomitant medical conditions such as diabetes and renal failure with dialysis treatment, advanced age and immunodeficiency are known risk factors [2] . The incidence of HS has increased in recent years [3] .…”

Section: Introductionmentioning

confidence: 99%

“…The incidence of HS has increased in recent years [3] . Advances in medical diagnostic and medical care that extend the life expectancy of elderly and immunocompromised populations, as well as an increase in the number of hospital-acquired infections, may be reasons for this trend [2] .…”

Section: Introductionmentioning

confidence: 99%

Infectious hematogenous lumbar spondylodiscitis caused by Actinotignum schaalii in a 74-year-old man: A case report

Röpke

Chwoika²,

Treber³

et al. 2022

International Journal of Surgery Case Reports

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Minimally invasive spine surgery as treatment for persistent infectious lumbar spondylodiscitis: a systematic review and meta-analysis

Cited by 4 publications

References 16 publications

Lower re-rupture rates but higher complication rates following surgical versus conservative treatment of acute achilles tendon ruptures: a systematic review of overlapping meta-analyses

Lower re-rupture rates but higher complication rates following surgical versus conservative treatment of acute achilles tendon ruptures: a systematic review of overlapping meta-analyses

Intraoperative Cone-Beam Computed Tomography Navigation Versus 2-Dimensional Fluoroscopy in Single-Level Lumbar Spinal Fusion: A Comparative Analysis

Infectious hematogenous lumbar spondylodiscitis caused by Actinotignum schaalii in a 74-year-old man: A case report

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