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Drug eluting bioactive glass ceramics for fusion in spondylodiscitis: a pilot study

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Abstract

Retrospective observational study. To determine the efficacy and safety of bioactive glass ceramics mixed with autograft in the treatment of spondylodiscitis. Thirty-four patients with spondylodiscitis underwent surgery using autologous bone graft augmented by antibiotic loaded bioactive glass ceramic granules. Twenty-five patients aging 6 to 77, completed 1-year follow-up. The lumbosacral junction was affected in 3, lumbar spine in 13, one each in the dorso-lumbar junction and sacrum, and 7 dorsal spines. The organism isolated was Mycobacterium tuberculosis in 15, Methicillin sensitive Staphylococcus aureus (MSSA) in 4, Pseudomonas aeruginosa in 4, Klebsiella pneumoniae in one, Burkholderia pseudomallei in 1, and mixed infections in 2. All patients had appropriate antibiotic therapy based on culture and sensitivity. Clinical and radiological evaluation of all the patients was done at 6 weeks, 3 months, 6 months, and 12 months after the surgery. Twenty-three patients improved clinically and showed radiographic fusion between 6 and 9 months. The patient with Burkholderia infection died due to fulminant septicemia with multi organ failure while another patient died at 9 months due to an unrelated cardiac event. The mean Visual Analogue Score (VAS) at the end of 1-year was 2 with radiological evidence of fusion in all patients. There were no re-infections or discharging wounds, and the 30-day re-admission rate was 0. Bioactive glass ceramics is a safe and effective graft expander in cases of spondylodiscitis. The absorption of antibiotics into the ceramic appears to help the elimination of infection.

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Authors and Affiliations

  1. Department of Spine Surgery, Bharati Vidyapeeth Medical College Hospital, Pune, India

    Mandar D. Borde & Venugopal K. Menon

  2. Department of Orthopaedics, Bharati Vidyapeeth Medical College Hospital, Pune, India

    Umesh P. Kanade, Sangram S. Rajale & Akash V. Mane

  3. Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum, Kerala, India

    Harikrishna Varma

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  1. Mandar D. Borde
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Contributions

MB, VKM and HV conceptualised the study; MB and VKM wrote the main text; MB, VKM and UK analysed and interpreted the data; UK, SR and AM prepared the figures; MB and VKM approved the version to be published.

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Correspondence to Mandar D. Borde.

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This study was performed in line with the principles of Declaration of Helsinki. Approval was granted by the Ethics Committee of University vide letter No: BVDUMC/IEC/130.

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The authors declare no competing interests.

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Borde, M.D., Menon, V.K., Kanade, U.P. et al. Drug eluting bioactive glass ceramics for fusion in spondylodiscitis: a pilot study. Neurosurg Rev 47, 80 (2024). https://doi.org/10.1007/s10143-024-02317-z

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