dc.contributor.advisor | Schatlo, Bawarjan PD Dr. | |
dc.contributor.author | Alaid, Awad | |
dc.date.accessioned | 2019-09-19T09:44:31Z | |
dc.date.available | 2019-09-19T09:44:31Z | |
dc.date.issued | 2019-09-19 | |
dc.identifier.uri | http://hdl.handle.net/21.11130/00-1735-0000-0003-C1BD-E | |
dc.identifier.uri | http://dx.doi.org/10.53846/goediss-7635 | |
dc.language.iso | deu | de |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | |
dc.subject.ddc | 610 | de |
dc.title | Wundheilungsraten nach Roboter-assistierter minimalinvasiver Pedikelschraubenosteosynthese im Vergleich zu konventioneller fluoroskopisch-gestützter Instrumentierung bei pyogener Spondylodiszitis. | de |
dc.type | doctoralThesis | de |
dc.title.translated | Robot guidance for percutaneous minimally invasive placement of pedicle screws for pyogenic spondylodiscitis is associated with lower rates of wound breakdown compared to conventional fluoroscopy-guided instrumentation | de |
dc.contributor.referee | Schatlo, Bawarjan PD Dr. | |
dc.date.examination | 2019-07-30 | |
dc.description.abstracteng | 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 methicillinresistant
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 i n p a t i e n t s wi t h pyogenic
spondylodiscitis in our large single-center study. | de |
dc.contributor.coReferee | Beil, Frank Timo Prof. Dr. | |
dc.subject.eng | Spine instrumentation . Spondylodiscitis . Robotic surgery . Spinal fusion . Methicillin-resistant Staphylococcus aureus | de |
dc.identifier.urn | urn:nbn:de:gbv:7-21.11130/00-1735-0000-0003-C1BD-E-2 | |
dc.affiliation.institute | Medizinische Fakultät | de |
dc.subject.gokfull | Neurochirurgie (PPN619876271) | de |
dc.identifier.ppn | 1677372737 | |