Our Summary

This research paper discusses a study that looked at the risk factors for infection after spinal surgery in patients with rheumatoid arthritis. People with rheumatoid arthritis are more likely to get infections than the general population, and an infection after spinal surgery can cause serious problems. The study found that 14.89% of the patients got an infection after their surgery. The researchers found that certain factors, such as the use of certain drugs, the patient’s age, whether the patient had diabetes, how long the patient had been suffering from rheumatoid arthritis, the length of the surgery, and the number of surgical procedures, did not significantly increase the risk of infection. However, all the patients who got an infection had undergone spinal surgery with instrumentation. This suggests that more attention needs to be paid to preventing infection in patients with rheumatoid arthritis who are undergoing this type of surgery. Interestingly, the use of biological drugs did not increase the risk of infection. This is the first study to show this.

FAQs

  1. What percentage of patients with rheumatoid arthritis developed an infection after spinal surgery according to the study?
  2. What factors were found not to significantly increase the risk of infection after spinal surgery in patients with rheumatoid arthritis?
  3. Did the use of biological drugs increase the risk of infection after spinal surgery in patients with rheumatoid arthritis according to the study?

Doctor’s Tip

One tip a doctor might give a patient about spinal surgery is to closely follow all post-operative care instructions, including keeping the surgical site clean and dry, taking prescribed medications as directed, and attending all follow-up appointments. It is important to report any signs of infection, such as increased pain, redness, swelling, or drainage from the incision, to your healthcare provider immediately. In addition, maintaining a healthy lifestyle, including eating a balanced diet, staying physically active, and avoiding smoking, can help support the healing process and reduce the risk of complications after spinal surgery.

Suitable For

Patients who are typically recommended spinal surgery include those with:

  1. Degenerative disc disease: This condition occurs when the discs between the vertebrae in the spine start to break down, causing pain and discomfort.

  2. Herniated disc: When the gel-like center of a spinal disc pushes through a crack in the outer layer, it can cause pain and numbness in the arms or legs.

  3. Spinal stenosis: This is a narrowing of the spinal canal, which can put pressure on the spinal cord and nerves, leading to pain, numbness, and weakness.

  4. Scoliosis: This is a condition in which the spine curves to the side, causing pain and discomfort.

  5. Spinal fractures: Trauma or osteoporosis can cause fractures in the vertebrae, which may require surgery to stabilize the spine.

  6. Tumors: Spinal tumors can cause pain and neurological symptoms, and surgery may be necessary to remove them.

  7. Infections: In some cases, infections in the spine may require surgical intervention to remove the infected tissue and prevent further complications.

Overall, patients who have not responded to conservative treatments such as physical therapy, medications, and injections may be considered for spinal surgery to alleviate their symptoms and improve their quality of life.

Timeline

Before spinal surgery:

  1. Patient consults with their doctor or specialist about their spinal issues.
  2. Patient undergoes various diagnostic tests such as X-rays, MRI, or CT scans to determine the extent of the spinal problem.
  3. Patient discusses surgical options with their healthcare provider and decides to proceed with spinal surgery.
  4. Patient undergoes pre-operative evaluations and tests to ensure they are healthy enough for surgery.

After spinal surgery:

  1. Patient undergoes the surgical procedure, which may involve spinal fusion, decompression, or other techniques depending on the specific issue.
  2. Patient is monitored closely in the recovery room for any immediate post-operative complications.
  3. Patient is typically kept in the hospital for a few days for observation and pain management.
  4. Patient begins physical therapy and rehabilitation to regain strength and mobility in the spine.
  5. Patient is discharged from the hospital and continues physical therapy and follow-up appointments with their healthcare provider.
  6. Patient may experience pain, discomfort, and limitations in mobility during the initial recovery period.
  7. Patient gradually improves over time with proper care and rehabilitation.
  8. Patient follows up with their healthcare provider regularly to monitor their progress and address any concerns.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with spinal surgery for someone with rheumatoid arthritis?
  2. How can I minimize the risk of infection after spinal surgery?
  3. Are there any specific precautions I should take before and after the surgery to reduce the risk of infection?
  4. How long is the recovery process expected to be, and what can I do to promote a smooth recovery and prevent complications?
  5. Are there any specific medications or treatments I should avoid before or after the surgery to reduce the risk of infection?
  6. How will my rheumatoid arthritis condition be managed during and after the surgery to minimize the risk of infection and other complications?
  7. What signs or symptoms should I watch out for that may indicate an infection after the surgery?
  8. How frequently will I need to follow up with my healthcare provider after the surgery to monitor for any signs of infection or other complications?
  9. Are there any lifestyle changes or modifications I should consider making to reduce the risk of infection after spinal surgery?
  10. Are there any specific exercises or physical therapy routines that could help prevent infections and promote healing after spinal surgery for someone with rheumatoid arthritis?

Reference

Authors: Koyama K, Ohba T, Ebata S, Haro H. Journal: Orthopedics. 2016 May 1;39(3):e430-3. doi: 10.3928/01477447-20160404-05. Epub 2016 Apr 12. PMID: 27064779