Spondylodiscitis instrumented fusion, a prospective case series on a standardized neurosurgical protocol with long term follow up

Rezvani, Majid; Veisi, Shaahin; Sourani, Arman; Ahmadian, Hamed; Foroughi, Mina; Mahdavi, Sadegh Baradaran; Nik Khah, Roham

doi:10.1016/j.injury.2023.111164

Cited by 5 publications

(3 citation statements)

References 40 publications

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“…The advantages of posterior access in thoracolumbar surgery include familiarity with the approach and widespread use of posterior pedicle screw placement among spinal surgeons [ 14 ]. Short and long spinal fusion techniques are almost equally used in cases of spondylodiscitis as long fixation is used more frequently in thoracolumbal junction [ 15 ]. In our case, short-segment fixation was performed considering the age of the patient and the possibility of growth inhibition.…”

Section: Discussionmentioning

confidence: 99%

Spondylodiscitis Following Perforated Acute Appendicitis: A Case Report

Angelova,

Davarski,

Kehayov

et al. 2024

Cureus

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Spondylodiscitis is a multifactorial disease of significant medical and socioeconomic importance, the treatment of which presents a challenge to clinicians and surgeons. Acute appendicitis is a common inflammatory disease in children, with postoperative complications occurring in up to 55% of cases. We present the case of a 15-year-old male with symptoms of severe back pain and fever two months following surgery for perforated appendicitis. The computed tomography (CT) revealed spondylodiscitis of T12-L1 spinal level. Discectomy and posterior pedicle-screw fixation were performed, followed by antibiotic treatment resulted in the resolution of preoperative symptoms. To the best of our knowledge, this is the third case of spondylodiscitis after perforated acute appendicitis in literature. Timely diagnosis and treatment in cases of spondylodiscitis are prerequisites for lowering the rate of permanent neurological deficits in these patients.

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Section: Discussionmentioning

confidence: 99%

Spondylodiscitis Following Perforated Acute Appendicitis: A Case Report

Angelova,

Davarski,

Kehayov

et al. 2024

Cureus

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“…Particularly, lattice-designed cages that mimic the web-like structure of native cancellous bone have shown excellent resistance to post-operative cage subsidence [ 28 , 29 , 60 ]. Conversely, a recent investigation conducted by Rezvani et al [ 61 ] revealed that in spondylodiscitis instrumented fusion, autologous bone graft mixtures exhibited a superior fusion rate alongside a lower mortality rate when compared to the use of titanium cages.…”

Section: Reviewmentioning

confidence: 99%

“…Rezvani et al also observed that utilizing an autologous bone graft mixture, as opposed to titanium cages, can lead to a notable increase in fusion rates coupled with a lower mortality rate. However, they noted that clinical outcomes may be adversely impacted by neurological symptoms present upon admission, comorbidities, and advanced age [ 61 ].…”

Section: Reviewmentioning

confidence: 99%

The Role of Bone Mineral Density in a Successful Lumbar Interbody Fusion: A Narrative Review

Bekas,

Zafeiris

2024

Cureus

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Background: The incidence of osteoporosis is a prime concern, especially in parts of the world where the population is aging, such as Europe or the US. Many new therapy strategies have been described to enhance bone healing. Lumbar interbody fusion (LIF) is a surgical procedure that aims to stabilize the lumbar spine by fusing two or more vertebrae using an interbody cage. LIF is a standard treatment for various spinal conditions, such as degenerative disc disease, spinal stenosis, and spondylolisthesis. However, successful fusion is challenging for patients with osteoporosis due to their reduced bone mineral density (BMD) and increased risk of cage subsidence, which can lead to implant failure and poor clinical outcomes. Methods: A comprehensive literature search yielded 220 articles, with 16 ultimately included. Keywords included BMD, cage subsidence, osteoporosis, teriparatide, and lumbar interbody fusion. Results: This review examines the relationship between BMD and LIF success, emphasizing the importance of adequate bone quality for successful fusion. Preoperative assessment methods for BMD and the impact of low BMD on fusion rates and patient outcomes are discussed. Additionally, techniques to improve fusion success in patients with weakened bone density, such as biological enhancement and BMD-matched interbody cages, are explored. However, consensus on the exact BMD threshold for a successful outcome remains elusive. Conclusion: While an apparent correlation between BMD and fusion rate in LIF procedures is acknowledged, conclusive evidence regarding the precise BMD threshold indicative of an increased risk of unfavorable outcomes remains elusive. Surgeons are advised to exercise caution in surgical planning and follow-up for patients with lower BMD. Furthermore, future research initiatives, particularly longitudinal studies, are encouraged to prioritize the examination of BMD as a fundamental risk factor, addressing gaps in the literature.

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