An infection following percutaneous vertebral augmentation with polymethylmethacrylate.
Arch Osteoporos. 2018 Apr 27;13(1):47
Authors: Park JW, Park SM, Lee HJ, Lee CK, Chang BS, Kim H
Though the incidence of an infection following vertebroplasty or kyphoplasty is uncommon, postoperative an infection and cement augmentation in preexistent spondylitis may cause life-threatening problems in frail sufferers with notable comorbidities. In such circumstances, pressing tradition and biopsy and the long-term use of correct antibiotics are obligatory.
PURPOSE: An infection following vertebral augmentation with polymethylmethacrylate (PMMA) is uncommon. We aimed to investigate 11 circumstances of pyogenic spondylitis and spondylodiscitis that occurred after vertebroplasty or kyphoplasty and to assessment related circumstances within the literature.
METHODS: All circumstances of postoperative spinal infections in our establishment between January 2005 and November 2016 that primarily underwent percutaneous vertebroplasty or kyphoplasty had been retrospectively reviewed. Eleven sufferers (imply age 76.three years) had been included.
RESULTS: The incidence of an infection following vertebroplasty/kyphoplasty was zero.36%. Postoperative an infection occurred in three of 826 circumstances. All sufferers underwent mixed surgical and antibiotic remedy due to neurologic deficit on the preliminary prognosis of the an infection or failure of prior medical remedy of the an infection. The surgical process was thorough debridement of contaminated tissue and materials together with PMMA following anterior column reconstruction through anterior/posterior/mixed method in 10 sufferers and percutaneous pedicle screw fixation alone in 1 affected person aged 96 years. The imply follow-up interval was 21.1 months after the revision operation, excluding one affected person who died 17 days after revision surgical procedure. Ten sufferers recovered from an infection.
CONCLUSIONS: Though the incidence of an infection following vertebroplasty or kyphoplasty is uncommon, postoperative an infection and cement augmentation in preexisting spondylitis can develop right into a life-threatening complication in frail sufferers with notable comorbidities. In treating contaminated vertebroplasty and kyphoplasty, quick tradition and biopsy and the long-term use of correct antibiotics are vital. Immediate surgical remedy ought to be thought of in case of great neurologic deficit, extreme instability resulting from contaminated fracture, and resistance to antibiotics.
PMID: 29704173 [PubMed – in process]