Abstract:
:Postoperative wound healing can pose a problem in patients undergoing instrumented surgery for pyogenic spondylodiscitis. Robotic guidance allows the minimally invasive placement of pedicle screws in the thoracolumbar spine. We assessed whether using this technique to perform minimally invasive surgery had an impact on wound healing in patients with pyogenic spondylodiscitis when compared to conventional open fluoroscopy-guided surgery. We reviewed charts of 206 consecutive patients who underwent instrumentation for pyogenic spondylodiscitis. The need for wound revision was the primary outcome measure. Patient variables and comorbidities as well as surgical technique (robotic versus fluoroscopy-guided) were analyzed. We also compared fluoroscopy times between the two groups. Multivariate regression analysis was performed to identify predictors of wound breakdown. A total of 206 patients underwent surgery for spondylodiscitis. Robotic surgical assistance was used for percutaneous instrumentation in 47.6% of cases (n = 98). Wound healing problems requiring revision occurred in 30 out of 206 patients (14.6%). Univariate analysis revealed a potential association of wound breakdown with (1) robotic technique, (2) age > 70 years, and (3) the presence of methicillin-resistant Staphylococcus aureus. After multivariate correction however, only robotic technique retained significance with an odds ratio of 0.39 (CI 95% 0.16-0.94; p = 0.035). Wound revision was required in eight out of 98 patients (8.1%) in the robot group and 22/108 (20%) in the conventional surgery group. Fluoroscopy times were significantly lower in the robot group with a mean of 123 ± 86 s in comparison with a mean of 157 ± 99 s in the conventional group (p = 0.014). While initially designed to improve the accuracy of pedicle screw placement, robot-assisted minimally invasive technique had a tangible effect on both radiation exposure and the rate of wound breakdown in patients with pyogenic spondylodiscitis in our large single-center study.
journal_name
Neurosurg Revjournal_title
Neurosurgical reviewauthors
Alaid A,von Eckardstein K,Smoll NR,Solomiichuk V,Rohde V,Martinez R,Schatlo Bdoi
10.1007/s10143-017-0877-1subject
Has Abstractpub_date
2018-04-01 00:00:00pages
489-496issue
2eissn
0344-5607issn
1437-2320pii
10.1007/s10143-017-0877-1journal_volume
41pub_type
杂志文章abstract::Many immune responses are controlled by genes of the major histocompatibility complex (MHC). In humans these include the loci encoding the HLA-A, -B, -C, -DR, -DQ, and -DP antigens, and many diseases have been linked with these. However, little information is available about any connection between malignant tumors and...
journal_title:Neurosurgical review
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journal_title:Neurosurgical review
pub_type: 杂志文章
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journal_title:Neurosurgical review
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journal_title:Neurosurgical review
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journal_title:Neurosurgical review
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