The effect of intradiscal vancomycin powder in the prevention of postoperative discitis: RCT study

Hasan, Ghazwan A; Sheta, Reda Ali; Raheem, Hayder Qatran; Al-Naser, Luay M

doi:10.1016/j.inat.2020.100705

Cited by 5 publications

(3 citation statements)

References 24 publications

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“…A study by Lopez et al 49 demonstrated the introduction of a vancomycin and cefazolin protocol to be effective in lowering the post-surgical revision rate for surgical site infection. Furthermore, a prospective RCT 50 demonstrated intra-operative intradiscal vancomycin powder to significantly reduce (1.4% infection rate) the rate of post-discectomy discitis compared to control (5.56% infection rate). It remains unclear which timing, dosages, and antibiotics are most effective for the specific comorbidities and clinical conditions of each patient.…”

Section: Pre and Perioperative Antibiotic Prophylaxismentioning

confidence: 99%

Interventional Therapy and Surgical Management of Lumbar Disc Herniation in Spine Surgery: A Narrative Review

Jung,

Han,

Song

et al. 2023

Orthopedic Reviews

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Significant advancements in lumbar disc herniation (LDH) management have been made in interventional pain therapy, operative therapy, peri-operative management, and cost analysis of various procedures. The present review aims to provide a concise narrative of all these topics, current trends, and possible future directions in the management of LDH. Interventional pain management using intradiscal injections often serves as a minimally invasive non-surgical approach. Surgical modalities vary, including traditional open laminectomy, microdiscectomy, endoscopic discectomy, tubular discectomy, percutaneous laser disc decompression, and transforaminal foraminotomy. Prevention of infections during surgery is paramount and is often done via a single-dose preoperative antibiotic prophylaxis. Recurrence of LDH post-surgery is commonly observed and thus mitigative strategies for prevention have been proposed including the use of annular closure devices. Finally, all treatments are well-associated with clear as well as hidden costs to the health system and society as described by billing codes and loss of patients’ quality-adjusted life-years. Our summary of recent literature regarding LDH may allow physicians to employ up-to-date evidence-based practice in clinical settings and can help drive future advancements in LDH management. Future longitudinal and comprehensive studies elucidating how each type of treatments fare against different types of herniations are warranted.

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Section: Pre and Perioperative Antibiotic Prophylaxismentioning

confidence: 99%

Interventional Therapy and Surgical Management of Lumbar Disc Herniation in Spine Surgery: A Narrative Review

Jung,

Han,

Song

et al. 2023

Orthopedic Reviews

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“…Additionally, under the influence of the inflammatory microenvironment, the reaction time of inflammation differs [ 8 , 9 ]. For example, after discectomy, the inflammatory cycle can be sustained for more than 14 days [ 7 , 10 ]. Furthermore, studies have shown that TNF-α, IL-1β and IL-6 play an important role in the acute phase [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Regulation of the inflammatory cycle by a controllable release hydrogel for eliminating postoperative inflammation after discectomy

Liu

Peng

et al. 2021

Bioactive Materials

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Surgery is the final choice for most patients with intervertebral disc degeneration (IDD). Operation-caused trauma will cause inflammation in the intervertebral disc. Serious inflammation will cause tissue defects and induce tissue degeneration, IDD recurrence and the occurrence of other diseases. Therefore, we proposed a scheme to treat recurrence after discectomy by inhibiting inflammation with an aspirin (ASP)-loaded hydrogel to restore the mechanical stability of the spine and relieve local inflammation. ASP-liposomes (ASP-Lips) were incorporated into a photocrosslinkable gelatin-methacryloyl (GelMA) via mixing. This material can effectively alleviate inflammation by inhibiting the release of high mobility group box 1 (HMGB1) from the nucleus to the cytoplasm. We further assessed the expression of inflammatory cytokines, such as interleukin 6 (IL-6) and tumor necrosis factor-α (TNF-α), and degeneration-related factors, such as type II collagen (COL-2), Aggrecan, matrix metallopeptidases-3 (MMP-3), MMP-13, a disintegrin and metalloproteinase with thrombospondin motifs-4 (ADAMTS-4) and ADAMTS-5 in rat nucleus pulpous cells. The level of IDD was analyzed through H&E, safranin-O staining and immunohistochemistry in rabbit samples. In vitro , we found that ASP-Lip@GelMA treatment significantly decreased inflammatory cytokines, MMP-3 and -13, and ADAMTS-4 and -5 and up-regulated COL-2 and Aggrecan via the inhibited release of HMGB-1 from the nucleus. In vivo, ASP-Lip@GelMA can effectively inhibit inflammation of local tissue after disc surgery and fill local tissue defects. This composite hydrogel system is a promising way to treat the recurrence of IDD after surgery without persistent complications.

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“…20 Furthermore, the literature reported spontaneous PS cases that involve multiple levels. [6][7][8][9][10][11] However, multiple noncontiguous spontaneous PS is rare and has only been explained in the literature by case reports and case series. We present a case report of multiple noncontiguous PS involving the cervical and lumbar spine following a mastectomy for breast cancer.…”

Section: Introductionmentioning

confidence: 99%

Multiple Noncontiguous Spondylodiscitis Following Mastectomy Secondary to Breast Carcinoma: Case Report and Literature Review

Hasan

ALi

Al-Jasim

et al. 2021

Egyptian Spine Journal

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Background Data: Multiple noncontiguous spontaneous pyogenic spondylodiscitis is rare and has only been explained in the literature by case reports and case series. Purpose: We present a case report of multiple noncontiguous spontaneous spondylodiscitis caused by E. coli involving the cervical and lumbar spine following a mastectomy for breast cancer. We will explain the difficulties in diagnosis, treatment, and follow-up with the concomitant. Study Design: A case report and literature review. Case Report: A middle-aged patient with a history of breast carcinoma underwent surgery. Two weeks after mastectomy, the patient developed severe cervical and lumbar spine pain and a low-grade fever (37.5-38.3 °C). Moreover, neurological examination revealed a right-sided antalgic gait, right-sided weakness, and a positive straight leg raising test. Upon presentation, elevated C-reactive protein (CRP) and white blood cells (WBC) were noted. Magnetic resonance imaging (MRI) showed consistent spondylodiscitis at C5-C6 and L3-L4 levels with stenotic features at L4-L5 levels. Surgical treatment of the lumbar region via posterior spinal instrumentation from L3 to L5 levels and decompression was done with a biopsy. Erythrocyte sedimentation rate (ESR) CRP titers were also performed for the follow-up plan, which showed a reduction in 3, 6, and 12 weeks postoperatively. Conservative treatment of the cervical region was undertaken with a complete cure. Conclusion: Multiple noncontiguous spondylodiscitis after nonspinal surgery is a relatively rare complication requiring a high suspicion index. Surgery is recommended in case of failure of conservative measures, neurological deficit, or mechanical instability as in this case. Furthermore, both clinical examination and blood tests should be used to assess the treatment outcomes. (2021ESJ246)

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The effect of intradiscal vancomycin powder in the prevention of postoperative discitis: RCT study

Cited by 5 publications

References 24 publications

Interventional Therapy and Surgical Management of Lumbar Disc Herniation in Spine Surgery: A Narrative Review

Interventional Therapy and Surgical Management of Lumbar Disc Herniation in Spine Surgery: A Narrative Review

Regulation of the inflammatory cycle by a controllable release hydrogel for eliminating postoperative inflammation after discectomy

Multiple Noncontiguous Spondylodiscitis Following Mastectomy Secondary to Breast Carcinoma: Case Report and Literature Review

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