During revision spinal surgery for aseptic indications, there remains a concern that the failure may have resulted from undetectable subclinical infection. In the common revision indications of hardware loosening and adjacent segment disease it is possible that bacterial colonization and low-grade infection precipitated the failure event. There is also significant controversy on the role infectious processes have in the development of degenerative disc disease (modic changes). In particular, this study will investigate whether discogenic colonization with Propionibacterium acnes (P. acnes) can be associated with modic changes. Whereas, in surgery for known spinal infection, epidural abscess and septic revisions, it is possible that standard culture techniques fail to detect polymicrobial flora or accurate speciation. This may lead to inappropriate antibiotic management that is not addressing the range of pathology present. There remains an incomplete understanding of the role that subclinical infection plays in aseptic spinal revision surgery and degenerative disc disease
Study Type
OBSERVATIONAL
Enrollment
450
Discarded tissue collected during surgery will be sent to the hospital microbiological lab for aerobic and anaerobic
Discarded tissue collected during surgery will be sent to an outside lab for testing using next generation sequencing (NGS)
Rothman Orthopaedic Institute
Philadelphia, Pennsylvania, United States
Postoperative complications
complications that patients experience after surgery will be noted from the patient chart after they have been evaluated by their surgeon
Time frame: 1 year
Patient Satisfaction
will be measured using the Short Form 12 Physical and Mental Score (SF-12)
Time frame: 1 year
Patient pain
will be measured using the Visual Analog Scale Neck and Arm Pain Score (VAS)
Time frame: 1 year
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