Database : MEDLINE
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[PMID]: 29524713
[Au] Autor:Aoun SG; Bedros N; El Ahmadieh TY; Kreck J; Mehta N; Al Tamimi M
[Ti] Title:Osteodiscitis of the Lumbar Spine Due To a Migrated Fractured Inferior Vena Cava Filter: Case Report.
[So] Source:World Neurosurg;, 2018 Mar 07.
[Is] ISSN:1878-8769
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Venous thromboembolism can be a significant cause of morbidity in the trauma population. Medical and surgical specialties have been pushing the indication for prophylactic filter placement. CASE DESCRIPTION: A 36-year-old man presented with axial lower back pain with a radicular right L2 component after lifting a heavy object. He had a history of penetrating brain trauma 3 years prior, with placement of a prophylactic inferior vena cava filter. His x-ray, computed tomography, and magnetic resonance imaging of the lumbar spine showed fracture of his filter, with migration of the fractured fragment through the inferior vena cava and into the L2-L3 disc space, and surrounding bony lysis and severe osteodiscitis. He was treated medically with intravenous and then oral antibiotics and improved clinically and radiographically. CONCLUSIONS: Conservative use of filter devices and early retrieval once their indication expires is paramount to avoid unnecessary complications.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  2 / 2328 MEDLINE  
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[PMID]: 29522179
[Au] Autor:Abusalameh M; Mahankali-Rao P; Earl S
[Ad] Address:Department of Rheumatology, Royal Devon & Exeter NHS Foundation Trust, Exeter, UK.
[Ti] Title:Discitis caused by rat bite fever in a rheumatoid arthritis patient on tocilizumab-first ever case.
[So] Source:Rheumatology (Oxford);, 2018 Mar 07.
[Is] ISSN:1462-0332
[Cp] Country of publication:England
[La] Language:eng
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.1093/rheumatology/key046

  3 / 2328 MEDLINE  
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[PMID]: 29462728
[Au] Autor:Rambo WM
[Ad] Address:Midlands Orthopaedics & Neurosurgery, 1910 Blanding St, Columbia, SC 29201, USA. Electronic address: William.Rambo@midorthoneuro.com.
[Ti] Title:Treatment of lumbar discitis using silicon nitride spinal spacers: A case series and literature review.
[So] Source:Int J Surg Case Rep;43:61-68, 2018 Feb 10.
[Is] ISSN:2210-2612
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Septic infection of a lumbar intervertebral disc is a serious disorder which is often difficult to diagnose and appropriately treat because of the rarity of the disease, the varied presentation of symptoms, and the frequency of low-back pain within the overall population. Its etiology can be pyogenic, granulomatous, fungal, or parasitic; its incidence is rising due to increased patient susceptibility and improved diagnostic tools. Conservative treatments involve antibiotics, physical therapy, and/or immobilization. More aggressive management requires discectomy, debridement, and spinal fusion in combination with local and systemic antibiotic administration. PRESENTATION OF CASES: Presented here are two case studies of lumbar pyogenic discitis associated with Escherichia coli and Candida albicans infections. Both required single-level anterior discectomy followed by spinal fusion using an antimicrobial silicon nitride (Si N ) spacer for stabilization without instrumentation. Localized antibiotics were used for only one of the patients. Follow-up CT and MRI scans showed that the infections had been resolved with no recurrence of symptoms. DISCUSSION: Si N is a relatively new spinal spacer material. It was utilized in these two cases because it reportedly provides a local environment which promotes rapid arthrodesis while resisting bacterial adhesion and biofilm formation. It is also highly compatible with X-ray, MRI, and CT imaging modalities. These properties were particularly attractive for these two cases given the patients' histories, presentation of symptoms, and the decision to forego instrumentation. CONCLUSION: The use of Si N as an antimicrobial spacer may lead to improved outcomes for patients with pyogenic discitis of the lumbar spine.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:Publisher

  4 / 2328 MEDLINE  
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[PMID]: 28449655
[Au] Autor:Tsai TT; Yang SC; Niu CC; Lai PL; Lee MH; Chen LH; Chen WJ
[Ad] Address:Department of Orthopaedic Surgery, Spine Section, Bone and Joint Research Center, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 5, Fusing St., Gueishan, Taoyuan, 333, Taiwan. tsai1129@gmail.com.
[Ti] Title:Early surgery with antibiotics treatment had better clinical outcomes than antibiotics treatment alone in patients with pyogenic spondylodiscitis: a retrospective cohort study.
[So] Source:BMC Musculoskelet Disord;18(1):175, 2017 04 27.
[Is] ISSN:1471-2474
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Pyogenic spondylodiscitis is a form of spinal infection that can result in severe back pain and even death. However, information is lacking on the relative effectiveness of various therapies. A retrospective chart review was conducted to investigate whether early surgical treatment of pyogenic spondylodiscitis coupled with intravenous antibiotics results in better patient prognoses than intravenous antibiotics therapy alone. METHODS: All patients treated for pyogenic spondylodiscitis at a single medical center from July 2006 to July 2011 were retrospectively reviewed. The inclusion criteria consisted of diagnosis of an early stage infection without neurological deficit, and patients without severe sepsis who were suitable candidates for early surgery as determined by a Pittsburgh bacteremia score < 4, and patients with delayed diagnosis and lost to outpatient follow-up were excluded. Clinical outcomes included patient demographic data, kyphosis angle, length of treatment, Oswestry Disability Index and visual analogue pain scale were analyzed. RESULTS: Of 90 enrolled patients, Group 1 (n = 47) received only antibiotic therapy and Group 2 (n = 43) received early surgery with post-surgery antibiotics for 2 to 4 weeks. Group 2 exhibited significantly better results than Group 1 for mean antibiotic administration period, mean hospitalization period, kyphotic angle correction. Of 61 patients who participated in telephone follow-up after discharge, Group 2 (n = 26) had significant lower mean ODI score, and mean back pain score than Group 1 (n = 35). CONCLUSIONS: While infection control was similar for both groups, patients treated with early surgery and antibiotics were hospitalized for fewer days and required less antibiotics than those treated with antibiotics alone, also having better functional outcomes. In short, early surgical treatment of pyogenic spondylodiscitis typically achieves a better prognosis, shorter hospitalization period, and subsequent significant improvement in kyphotic deformity and quality of life.
[Mh] MeSH terms primary: Anti-Bacterial Agents/therapeutic use
Communicable Diseases/drug therapy
Communicable Diseases/surgery
Discitis/drug therapy
Discitis/surgery
[Mh] MeSH terms secundary: Adolescent
Adult
Aged
Aged, 80 and over
Communicable Diseases/diagnostic imaging
Discitis/diagnostic imaging
Double-Blind Method
Female
Follow-Up Studies
Humans
Male
Middle Aged
Retrospective Studies
Treatment Outcome
Young Adult
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Name of substance:0 (Anti-Bacterial Agents)
[Em] Entry month:1802
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[Js] Journal subset:IM
[Da] Date of entry for processing:170429
[St] Status:MEDLINE
[do] DOI:10.1186/s12891-017-1533-1

  5 / 2328 MEDLINE  
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[PMID]: 29452925
[Au] Autor:Cox M; Curtis B; Patel M; Babatunde V; Flanders AE
[Ad] Address:Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, United States. Electronic address: mougnyan.cox@uphs.upenn.edu.
[Ti] Title:Utility of sagittal MR imaging of the whole spine in cases of known or suspected single-level spinal infection: Overkill or good clinical practice?
[So] Source:Clin Imaging;51:98-103, 2018 Feb 13.
[Is] ISSN:1873-4499
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: Multi-sequence sagittal magnetic resonance imaging (MRI) of the entire spine is performed in patients with known single level spondylodiscitis. Our objective is to determine the frequency of multifocal infection. METHODS: After IRB approval, a retrospective five-year review of all patients with spondylodiscitis was performed. RESULTS: MRI identified 82 patients with single-level infection. All 82 had entire spine imaging performed within 72 h of admission, showing additional non-continuous sites of infection in 19 patients (23%). Remote levels of spondylodiscitis were present in 11 patients (13%). CONCLUSION: Multi-sequence sagittal MRI of the entire spine may be helpful in patients with known single-level spine infection.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180217
[Lr] Last revision date:180217
[St] Status:Publisher

  6 / 2328 MEDLINE  
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[PMID]: 29417782
[Au] Autor:Chen L; Cheng J; Li B; Zhan FB; Zhang Y; Feng SL
[Ad] Address:Department of Spinal Surgery, Central Hospital of the Three Changjiang River Gorges of Chongqing, Chongqing 404000, China; chenlinspine@163.com.
[Ti] Title:[Posterior debridement, interbody fusion, internal fixation for treatment of lumbar discitis].
[So] Source:Zhongguo Gu Shang;30(5):475-478, 2017 May 25.
[Is] ISSN:1003-0034
[Cp] Country of publication:China
[La] Language:chi
[Ab] Abstract:OBJECTIVE: To evaluate the clinical effects of posterior debridement, interbody fusion with internal fixation in the treatment of lumbar discitis. METHODS: The clinical data of 13 patients with lumbar discitis treated from January 2005 to June 2012 was retrospectively analyzed. There were 9 males and 4 females, aged from 31 to 68 years old with an average of 56 years old. There were 2 cases on L3, 4, 4 cases on L4, 5, and 7 cases on L5S1. Two cases complicated with diabetes, 4 cases with hypertension, and 1 case with obsolete pulmonary tuberculosis. ESR level of 13 cases was 12-89 mm/h with an average of 42 mm/h; and C reactive protein fluctuations level was level 8-114 ng/L with an average of 47 ng/L. All the patients denied history of operation or injection, and the main symptom was severe pain and limitation of motion in lumbar, with no efficacy for conservative methods. Preoperative VAS was from 5 to 10 points with an average of 7.8 points. All patients were treated with posterior debridement, interbody fusion, and internal fixation. RESULTS: All the patients left hospital after wound healing, and the effective antibiotics were continuously used for 4 weeks intravenously and 2 weeks for orally. All patients were followed up from 7 to 24 months with an average of 18 months. VAS decreased for 0-1 point. No internal fixation breakage, and recurrence were found. Bone graft got fusion, and postoperative pathology showed phlogistic changes. CONCLUSIONS: One-stage posterior debridement, interbody fusion with internal fixation was an effective method in treating lumbar discitis, and it lead to quicker relived pain relief and earlier mobilization.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180208
[Lr] Last revision date:180208
[Cl] Clinical Trial:ClinicalTrial
[St] Status:In-Process
[do] DOI:10.3969/j.issn.1003-0034.2017.05.016

  7 / 2328 MEDLINE  
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[PMID]: 29337085
[Au] Autor:Watkins RR; Yendewa G; Burdette SD; Horattas S; Haller NA; Mangira C; Salata RA; Bonomo RA
[Ad] Address:Division of Infectious Diseases, Cleveland Clinic Akron General, Akron, OH, USA; Department of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA. Electronic address: WatkinR2@ccf.org.
[Ti] Title:DISC: Describing Infections of the Spine treated with Ceftaroline.
[So] Source:J Glob Antimicrob Resist;, 2018 Jan 11.
[Is] ISSN:2213-7173
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:OBJECTIVES: Spine infections lead to considerable morbidity and high cost to the global health care system. Currently, the evidence for using ceftaroline, an advanced-generation cephalosporin active against methicillin-resistant Staphylococcus aureus (MRSA), in spine infections is limited. METHODS: Describing Infections of the Spine treated with Ceftaroline (DISC) is a multicenter retrospective cohort study that evaluated ceftaroline for treating spine infections. Patients were included if they were≥18years of age, diagnosed with a spine infection, and treated with ceftaroline for at least 28 days. A control group was identified with the same inclusion criteria as the study population except they were treated with a comparator antibiotic for at least 28 days. RESULTS: Thirty-seven patients were included in both the ceftaroline and control groups. MRSA was the most commonly identified pathogen. With no differences between groups in age, sex, race, or comorbidities (with the exception of chronic kidney disease), treatment with ceftaroline led to similar clinical success compared to the controls. Multivariate regression analysis did not show significant differences between the two groups in terms of clinical success after controlling for other covariates (adjusted odds ratio, 1.59; P=0.711). More patients who received ceftaroline were discharged to an extended care facility or a rehabilitation facility than home compared to controls (81% vs. 54%, respectively; P=0.024). Side effects and toxicities were rare, including one case of eosinophilic pneumonia in the ceftaroline group. CONCLUSIONS: Ceftaroline appears to be safe and effective therapy for infections of the spine, including from MRSA.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180116
[Lr] Last revision date:180116
[St] Status:Publisher

  8 / 2328 MEDLINE  
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[PMID]: 29225127
[Au] Autor:Martin S; Lindsay R; Baker RC
[Ad] Address:Core Trainee, Royal Victoria Hospital Belfast, Belfast, Northern Ireland. Electronic address: Smartin381@qub.ac.uk.
[Ti] Title:Simultaneous Endovascular Repair of a Thoracic Aortic Injury during Posterior Pedicle Screw Removal: A Case Report.
[So] Source:Ann Vasc Surg;, 2017 Dec 08.
[Is] ISSN:1615-5947
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:Posterior spinal stabilization is a technically demanding procedure which is increasing in popularity. Since this increase in popularity, complications, including screws misplacement, are being highlighted. Accuracy rates are higher when imaging modalities are used intraoperatively. Vascular injuries following posterior spinal stabilization are rare and are usually discovered late on subsequent imaging. Immediate perioperative compromise is rare, but nonetheless, resultant vascular injuries can be life threatening. A 72-year-old woman had a posterior spinal stabilization for severe pain caused by discitis. Routine computed tomography scan, 2 weeks postoperatively, detected an incidental thoracic aortic injury due to a misplaced pedicle screw. Given the rarity of this complication, there is no guideline for the management of resultant aortic injuries. Options described in the literature include thoracotomy with open vascular repair and newer endovascular techniques. We describe a novel method of simultaneous endovascular repair of a thoracic aortic injury during posterior pedicle screw removal with the patient in the right decubitus position. Surgeons operating near high-risk vascular structures should use intraoperative imaging modalities to guide screw placement and reduce subsequent complication rates. During endovascular repair of resultant aortic injuries, several factors must be considered. In particular, the challenge of turning a patient with open groin access and an endovascular stent in place. This must be carried out with extreme care to avoid the following risks: loss of access, damage to the access vessels and bleeding, displacement of the stent or deployment wires, and loss of the sterile field.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180114
[Lr] Last revision date:180114
[St] Status:Publisher

  9 / 2328 MEDLINE  
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[PMID]: 29299700
[Au] Autor:Colip CG; Lotfi M; Buch K; Holalkere N; Setty BN
[Ad] Address:Boston University Medical Center, 1 Boston Medical Center Pl, Boston, MA, 02118, USA. chuckcolip@gmail.com.
[Ti] Title:Emergent spinal MRI in IVDU patients presenting with back pain: do we need an MRI in every case?
[So] Source:Emerg Radiol;, 2018 Jan 03.
[Is] ISSN:1438-1435
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: Spinal MRI is the exam of choice for the workup of patients with suspected spinal infection. In this retrospective study, we assess the value of obtaining contrast-enhanced spinal MRI for patients presenting to the emergency department (ED) with acute back pain and a history of intravenous drug use (IVDU). METHODS: A retrospective IRB-approved, HIPAA compliant review of the imaging findings, reports and electronic charts of 167 consecutive IV drug-using patients (M/F = 96:71, mean age = 40 years) that presented to the ED with acute back pain over a 55-month period and underwent contrast-enhanced spinal MRI within 24 h. Fisher's exact test was used to identify statistically significant (p < 0.05) associations with MRI findings. RESULTS: Evidence of infectious spondylitis was demonstrated on the spinal MRIs of 39.5% (n = 66) of 167 patients, all of whom were admitted, and nearly half (48.5%; 32/66) underwent surgical or percutaneous intervention. Statistically significant differences in the decision to admit, blood cultures, and the type of treatment was demonstrated in patients with findings of spinal infection on MRI (p < 0.05). CONCLUSION: Use of emergent spinal MRI in the workup of IVDU patients with acute back pain is justified despite the resultant pressure on MRI scanner, technologist, and interpretation time.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180104
[Lr] Last revision date:180104
[St] Status:Publisher
[do] DOI:10.1007/s10140-017-1572-9

  10 / 2328 MEDLINE  
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[PMID]: 29185277
[Au] Autor:Eshed I; Lidar M
[Ad] Address:Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
[Ti] Title:MRI Findings of the Sacroiliac Joints in Patients with Low Back Pain: Alternative Diagnosis to Inflammatory Sacroiliitis.
[So] Source:Isr Med Assoc J;19(11):666-669, 2017 Nov.
[Is] ISSN:1565-1088
[Cp] Country of publication:Israel
[La] Language:eng
[Ab] Abstract:BACKGROUND: Magnetic resonance imaging (MRI) is the most sensitive imaging modality for the detection of sacroiliitis. Diagnosing sacroiliitis on MRI is not always straightforward and can be challenging in some cases. OBJECTIVES: To evaluate the prevalence of alternative diagnoses suggested by MRI and characterize the MR appearance of the most common ones. METHODS: Consecutive MRI examinations of the sacroiliac joints (SIJ) performed between 2005 and 2012 were retrospectively evaluated for the presence of structural and active sacroiliitis findings according to the Assessment of SpondyloArthritis International Society guidelines. Alternative diagnoses, including degenerative changes, diffuse idiopathic skeletal hyperostosis (DISH), Osteitis condensans ilii (OCI), septic sacroiliitis/discitis, stress reaction as well as anatomic variants, were registered. RESULTS: We evaluated 281 MRI examinations, 116 males, 165 females, average age 44 ± 15 years. Sacroiliitis was found in 71 examinations (25%) and alternative diagnoses were suggested in 87 (31%) (OCI 8.9%, anatomic variants 5.3%, septic sacroiliitis 5.3%, degenerative findings 4.3%, diffuse idiopathic skeletal hyperostosis [DISH] 1.5%, stress reaction 0.7%, tumor 0.3%). A normal examination was found in the remaining 123 examinations. Patients with alternative diagnoses were older than those with sacroiliitis (62 vs. 47 years of age, respectively, P > 0.05). Alternative pathologies in the SIJ were significantly more common in females (66) than males (21), P < 0.05. CONCLUSIONS: A substantial proportion of patients with suspected sacroiliitis had normal SIJ while the rest were more commonly diagnosed with other pathologies. A referral by an experienced rheumatologist may improve the sensitivity and specificity of this important examination.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171129
[Lr] Last revision date:171129
[St] Status:In-Data-Review


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