William F Young1, Peter Axelrod, Jack Jallo. 1. Department of Neurosurgery, Temple University School of Medicine, Philadelphia, PA, USA. wyoung@fwnc.com
Abstract
STUDY DESIGN: This is a retrospective study consisting of medical records review and evaluation of pertinent radiographs. OBJECTIVES: In this study, complications and outcomes are reviewed in a series of HIV-positive patients undergoing spinal surgery. Surgery was performed for conditions that were unrelated to HIV infection. METHODS: From the period 1996 to 2000, we identified 10 seropositive patients who underwent spinal procedures for conditions that did not arise as a complication of HIV infection. A retrospective review was done, which included inpatient and out patient records. RESULTS: A total of 6 women and 5 men who were HIV-positive underwent spinal surgery during the time period reviewed. Surgery was performed for a variety of conditions, including lumbar disc herniaition, degenerative disc disease, cervical disc herniation, spinal fractures, and Arnold-Chiari malformation. The mean CD4 count was 279 cells/mm3 before surgery. All patients had at least 6 months of conservative management before surgery, except in the case of those who had spinal fractures. Two patients sustained postoperative complications: 1 patient developed a superficial wound infection, which was successfully treated with antibiotics, and 1 patient experienced prolonged fever (7 days) after surgery, which resolved without a clear diagnosis. All patients were improved after surgery (mean follow-up, 29.3 months) CONCLUSIONS: Many physicians have held a nihilistic approach, when it comes to the treatment of HIV-positive persons. However, our results in this small series of patients suggest that spinal surgery may be appropriate and can be performed with acceptable outcomes in selected patients.
STUDY DESIGN: This is a retrospective study consisting of medical records review and evaluation of pertinent radiographs. OBJECTIVES: In this study, complications and outcomes are reviewed in a series of HIV-positive patients undergoing spinal surgery. Surgery was performed for conditions that were unrelated to HIV infection. METHODS: From the period 1996 to 2000, we identified 10 seropositive patients who underwent spinal procedures for conditions that did not arise as a complication of HIV infection. A retrospective review was done, which included inpatient and out patient records. RESULTS: A total of 6 women and 5 men who were HIV-positive underwent spinal surgery during the time period reviewed. Surgery was performed for a variety of conditions, including lumbar disc herniaition, degenerative disc disease, cervical disc herniation, spinal fractures, and Arnold-Chiari malformation. The mean CD4 count was 279 cells/mm3 before surgery. All patients had at least 6 months of conservative management before surgery, except in the case of those who had spinal fractures. Two patients sustained postoperative complications: 1 patient developed a superficial wound infection, which was successfully treated with antibiotics, and 1 patient experienced prolonged fever (7 days) after surgery, which resolved without a clear diagnosis. All patients were improved after surgery (mean follow-up, 29.3 months) CONCLUSIONS: Many physicians have held a nihilistic approach, when it comes to the treatment of HIV-positive persons. However, our results in this small series of patients suggest that spinal surgery may be appropriate and can be performed with acceptable outcomes in selected patients.
Authors: Joseph T King; Adam J Gordon; Melissa F Perkal; Stephen Crystal; Ronnie A Rosenthal; Maria C Rodriguez-Barradas; Adeel A Butt; Cynthia L Gibert; David Rimland; Michael S Simberkoff; Amy C Justice Journal: Spine (Phila Pa 1976) Date: 2012-04-01 Impact factor: 3.468
Authors: James W M Kigera; Masja Straetemans; Simplice K Vuhaka; Ingeborg M Nagel; Edward K Naddumba; Kimberly Boer Journal: PLoS One Date: 2012-08-08 Impact factor: 3.240