PDF(Pubmed)
Abstract：
UNASSIGNED: 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?
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
摘要：
■全椎间盘置换术（TDR）广泛用于治疗颈椎和腰椎病变。虽然TDR感染,尤其是延迟感染，并不常见,结果可能是毁灭性的，关于临床管理的共识仍然难以捉摸。在这篇文献综述中，我们问：（1）报告的TDR感染率是多少；（2）TDR感染的临床特征是什么；（3）如何管理TDR患者的感染？
■我们使用PubMed和Embase进行了文献搜索，以确定报告TDR感染率的研究，TDR感染的识别和管理，或具有阳性文化的TDR失败。审查了20项数据库研究（17项集中于颈椎，3项集中于腰椎）和10例病例报告，代表15例患者，以及设备安全性和有效性数据报告摘要。
■我们发现感染是如何被诊断的缺乏明确性，表明临床方法的差异，并强调需要TDR感染的标准定义。此外，虽然报告的感染率很低，缺乏明确的定义阻碍了稳健的数据分析,并且可能导致文献中的漏报.我们发现，治疗策略和成功取决于几个因素，包括患者症状和发病时间，微生物类型,和植入物定位/稳定性。
■尽管现有文献中的治疗策略各不相同，消除感染和重建脊柱的常见做法出现了。结果将为未来的工作提供信息，以创建更可靠的TDR感染定义以及管理建议。
■我们使用PubMed和Embase进行了文献搜索，以确定报告TDR感染率的研究，TDR感染的识别和管理，或具有阳性文化的TDR失败。审查了20项数据库研究（17项集中于颈椎，3项集中于腰椎）和10例病例报告，代表15例患者，以及设备安全性和有效性数据报告摘要。
■我们发现感染是如何被诊断的缺乏明确性，表明临床方法的差异，并强调需要TDR感染的标准定义。此外，虽然报告的感染率很低，缺乏明确的定义阻碍了稳健的数据分析,并且可能导致文献中的漏报.我们发现，治疗策略和成功取决于几个因素，包括患者症状和发病时间，微生物类型,和植入物定位/稳定性。
■尽管现有文献中的治疗策略各不相同，消除感染和重建脊柱的常见做法出现了。结果将为未来的工作提供信息，以创建更可靠的TDR感染定义以及管理建议。
