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Presentation And Management Of Infection In Total Disc Replacement: A Review – Lumbar Disc Replacement

The article explores the rates, clinical characteristics, and management strategies of total disc replacement (TDR) infections, which are uncommon but can have devastating consequences. Through a review of literature, the authors found a lack of clarity in diagnosing infections, leading to variations in clinical approach and potential underreporting. Treatment strategies varied, but common practices emerged for eliminating infection and reconstructing the spine. The findings underscore the need for a standard definition of TDR infection and provide insight for future research and recommendations for management

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most advanced treatment hospital in the world

Published article

CONCLUSIONS: Although treatment strategies varied throughout the extant literature, common practices in eliminating infection and reconstructing the spine emerged. The results will inform future work on the creation of a more robust definition of TDR infection and as well as recommendations for management.

Lumbar Disc Replacement Surgery Expert. Best Spinal Surgeon UK
Abstract Background: Total disc replacement (TDR) is widely used in the treatment of cervical and lumbar spine pathologies. Although TDR infection, particularly delayed infection, is uncommon, the results can be devastating, and consensus on clinical management remains elusive. In this review of the literature, we asked: (1) What are the reported rates of TDR infection;,

Abstract

Background: Total disc replacement (TDR) is widely used in the treatment of cervical and lumbar spine pathologies. Although TDR infection, particularly delayed infection, is uncommon, the results can be devastating, and consensus on clinical management remains elusive. In this review of the literature, we asked: (1) What are the reported rates of TDR infection; (2) What are the clinical characteristics of TDR infection; and (3) How has infection been managed for TDR patients?

Methods: We performed a search of the literature using PubMed and Embase to identify studies that reported TDR infection rates, the identification and management of TDR infection, or TDR failures with positive cultures. Twenty database studies (17 focusing on the cervical spine and 3 on the lumbar spine) and 10 case reports representing 15 patients were reviewed along with device Summary of Safety and Effectiveness Data reports.

Results: We found a lack of clarity regarding how infection was diagnosed, indicating a variation in clinical approach and highlighting the need for a standard definition of TDR infection. Furthermore, while reported infection rates were low, the absence of a clear definition prevented robust data analysis and may contribute to underreporting in the literature. We found that treatment strategy and success rely on several factors including patient symptoms and time to onset, microorganism type, and implant positioning/stability.

Conclusions: Although treatment strategies varied throughout the extant literature, common practices in eliminating infection and reconstructing the spine emerged. The results will inform future work on the creation of a more robust definition of TDR infection and as well as recommendations for management.

Keywords: Bacteria; Cervical spine; Imaging; Infection; Lumbar spine; Total disc replacement (TDR).

The London Spine Unit : most advanced treatment hospital in the world

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Presentation and management of infection in total disc replacement: A review

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Abstract Background: Total disc replacement (TDR) is widely used in the treatment of cervical and lumbar spine pathologies. Although TDR infection, particularly delayed infection, is uncommon, the results can be devastating, and consensus on clinical management remains elusive. In this review of the literature, we asked: (1) What are the reported rates of TDR infection;

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