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Jordan Gruskay, Jeremy Smith, Christopher K. Kepler, Kristen Radcliff, James Harrop, Todd Albert and Alexander Vaccaro

P ostoperative SSIs are one of the most common complications following spine surgery. The incidence of postoperative infection reported after spine surgery is variable, ranging from 0.5% to 20%. 11 , 15 , 25 , 35 , 39 , 43 , 44 These SSIs result in longer hospital stays, a 5-fold risk of hospital readmission, and a 60% higher chance of ICU admission, and are associated with a 2-fold increase in postoperative deaths. 20 , 23 Because of the relatively high incidence and the difficulty of treating SSIs, a thorough understanding of the epidemiology and

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Hematogenous pyogenic facet joint infection of the subaxial cervical spine

A report of two cases and review of the literature

Anthony J. Muffoletto, Remi Nader, Richard M. Westmark, Haring J. W. Nauta, Kim J. Garges and Alexander G. Hadjipavlou

H ematogenous pyogenic facet joint infection is a rarely diagnosed condition that occurs primarily in the lumbar spine. We could only identify one other case involving the subaxial cervical spine (from C-7 to T-1) in the literature. 32 We report on two new cases of pyogenic cervical facet joint infection. In the lumbar spine, a facet joint infection may resolve spontaneously. 6, 17, 20 Some are associated with epidural abscess formation, 5, 12, 14, 21, 23, 29 which may lead to a potentially severe neurological deficit. 14, 23 In both cases of the

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Margaret A. Olsen, Jennie Mayfield, Carl Lauryssen, Louis B. Polish, Marilyn Jones, Joshua Vest and Victoria J. Fraser

S urgical site infections are the most common type of nosocomial infection among surgically treated patients in the US, resulting in increased rates of morbidity and mortality, hospital LOS, and cost. 10, 12 The most recent summary from the National Nosocomial Infections Surveillance System indicated a 1.2% rate of SSI in laminectomy-treated and 2.4% SSI rate in spinal fusion—treated patients. 8 Rates of SSI reported from individual institutions have ranged from 0 to 15%, depending on the type of surgery, diagnosis, and use of instrumentation. 1, 9, 19, 22

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Steven M. Kurtz, Edmund Lau, Kevin L. Ong, Leah Carreon, Heather Watson, Todd Albert and Steven Glassman

I nfection can be a devastating complication of instrumented spinal fusion because it may lead to excess morbidity and poor patient outcomes, including pseudarthrosis and osteomyelitis. 4 An SSI following instrumented spinal fusion can be differentiated by the following: depth of penetration; timing relative to index surgery; and treatment strategy. An SSI is classified as either superficial or deep wound infection, depending on whether the infection is subcutaneous or subfascial. Deep infections indicate that the peri-implant tissues have been

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Mahmoud Rayes, Chaim B. Colen, Diaa A. Bahgat, Tetsuhiro Higashida, Murali Guthikonda, Setti Rengachary and Hazem A. Eltahawy

S pinal infections account for 2–4% of all cases of osteomyelitis. 30 , 42 , 48 Most cases of spinal infection are treated conservatively with appropriate antibiotic therapy. However, under certain situations, such as abscess formation, unresponsiveness to antibiotics, intolerable pain, and presence of neurological deficit, surgery is indicated. 2 , 3 If blood cultures fail to identify the offending organism, samples obtained during surgery can be quite helpful. When the infective process or extensive debridement endangers the stability of the spine, the

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Daniel M. Sciubba, Clarke Nelson, Beryl Gok, Matthew J. McGirt, Gregory S. McLoughlin, Joseph C. Noggle, Jean Paul Wolinsky, Timothy F. Witham, Ali Bydon and Ziya L. Gokaslan

such complicated tumor resections, often involving complex wound reconstruction, such infections can dramatically complicate the postoperative course for patients. 5 , 19 , 20 , 24 In an attempt to identify potential factors associated with an increased risk of infection following sacral tumor resections, a retrospective analysis was conducted over a 5-year period at a single institution. Particular attention was given to potential preoperative risk factors for SSI, characteristics of operative technique, and perioperative course. Methods Between 2002 and

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Anuj Singla, Scott Yang, Brian C. Werner, Jourdan M. Cancienne, Ali Nourbakhsh, Adam L. Shimer, Hamid Hassanzadeh and Francis H. Shen

, their use may compromise subsequent surgical procedures and their outcomes. Recent studies have suggested a higher incidence of postoperative infection in patients who undergo lumbar spinal surgeries after preoperatively administered epidural injections. 34 , 36 The goal of the present study was to use a large national database to analyze the association between preoperative LESIs administered at various time intervals before lumbar spinal fusion and the incidence of surgical site infection. Methods The PearlDiver patient record database (PearlDiver Inc.), an

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Chong-Suh Lee, Kyung-Chung Kang, Sung-Soo Chung, Ki-Tack Kim and Seong-Kee Shin

P ostoperative infection is one of the most devastating complications in spinal surgeries. Possible contributions to spinal infection include various patient factors, surgical techniques, length of surgery, and different types of bone grafts used in fusion surgery. 2 , 5 , 11 Among bone grafts, contamination of local bone autograft is considered an important cause of postoperative spinal infection, but few data exist regarding the association of results of microbiological culture of local bone with postoperative spinal infection. 10 Recently, although

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Kaisorn L. Chaichana, Mohamad Bydon, David R. Santiago-Dieppa, Lee Hwang, Gregory McLoughlin, Daniel M. Sciubba, Jean-Paul Wolinsky, Ali Bydon, Ziya L. Gokaslan and Timothy Witham

L umbar fusion is a relatively common spine procedure, accounting for over 400,000 procedures annually. 9 , 35 In addition, there was an approximate 15-fold increase in the number of lumbar instrumentation procedures performed from 2002 to 2007. 9 As the number of spinal fusion procedures increases, the number of complications is also expected to rise. 9 One of these complications is spinal infection. 9 Postoperative spinal infection occurs in approximately 1%–5% of patients undergoing spine surgery. 5 , 13 , 28 This risk is highest in patients

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Alexander Hammer, Dorit Wolff, Walter Geißdörfer, Michael Schrey, Renate Ziegler, Hans-Herbert Steiner and Christian Bogdan

, the mortality rate ranges from 7% to 13%. 8 , 12 However, following appropriate antibiotic therapy, rat bite fever has a good prognosis. 3 , 19 Severe complications of rat bite fever are endocarditis, spread of the pathogen into organs leading to abscess formation (for example, brain abscess), myocarditis, respiratory failure, and overwhelming septicemia. 3 , 6–8 , 12 , 15 , 19 Frequently, children are affected. 19 S. moniliformis infections of the human spine can occur in the form of an epidural abscess, spondylodiscitis, or a psoas abscess and have only