12 results on '"Fantoni M."'
Search Results
2. New classification for the treatment of pyogenic spondylodiscitis: validation study on a population of 250 patients with a follow-up of 2 years
- Author
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Pola, Enrico, Autore, G., Formica, V. M., Pambianco, V., Colangelo, D., Cauda, R., and Fantoni, M.
- Published
- 2017
- Full Text
- View/download PDF
Catalog
3. Minimally invasive surgery for the treatment of thoraco lumbar pyogenic spondylodiscitis: indications and outcomes.
- Author
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POLA, E., PAMBIANCO, V., AUTORE, G., CIPOLLONI, V., and FANTONI, M.
- Abstract
OBJECTIVE: Pyogenic spondylodiscitis (PS) is a non-specific infection affecting intervertebral disks and adjacent vertebral bodies. Once considered a rare condition in developed countries, the incidence of PS has been increasing alarmingly and still represents a challenge for clinicians and orthopedic surgeons. New minimally invasive techniques have been proposed but the proper indications for these different approaches remain controversial. The aim of this study was to describe the available minimally invasive surgical techniques and to evaluate their proper indications through a review of recent literature. MATERIALS AND METHODS: Over 30 articles of recent scientific literature have been reviewed and analyzed. Studies were searched through the PubMed database using the key words: spondylodiscitis, minimally invasive, and surgical treatment. The most interesting and valid techniques and results have been reported. Despite the exclusion of case reports, all the available studies have been conducted on small groups of patients. Indications for each technique have been reported according to a clinical-radiological classification of PS. RESULTS: Six of the most widely used minimally invasive surgical techniques have been described. High success rates have been reported in terms of preventing the progression of spondylodiscitis into more destructive forms, reduction of time and operative hospitalization, faster pain relief, early mobilization, and achievement of microbiological diagnosis. CONCLUSIONS: The role of minimally invasive surgery in the treatment of PS is rapidly expanding. Reducing surgery-related morbidity in these frail patients is possible and often necessary. However, while more and more new techniques are being proposed, still few clinical data are available. Clinical comparison studies with open traditional surgery should be encouraged, and more attention should be paid to long-term outcomes. For the present, the indications for minimally invasive procedures should, therefore, be evaluated on a case by case basis and on clinical and radiological findings. [ABSTRACT FROM AUTHOR] more...
- Published
- 2019
4. Post-operative spondylodiscitis
- Author
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Luigi Aurelio NASTO, Colangelo, D., Rossi, B., Fantoni, M., Pola, E., Pola, E, Nasto, La, Colangelo, D, Rossi, B, and Fantoni, M
- Subjects
spondylodisciti ,spondylodiscitis ,post-operative complication ,Settore MED/33 - MALATTIE APPARATO LOCOMOTORE - Abstract
Postoperative spine infections (PSIs) are a frequent and dreaded complication of spine surgery. Although different studies have been published, the prevalence of PSIs is thought to be about 5% for most spine surgical procedures. Different risk factors have been identified for PSIs. Among the others, extensive soft tissue dissection, longer operative time, soft tissue devitalization, and use of surgical instrumentation have been associated with higher risks of infection. Direct inoculation during surgery is the common infection route for PSIs. Gram-positive cocci (such as Staphylococcus aureus, Staphylococcus epidermidis and beta-hemolytic streptococci) are the most common pathogens. Gram-negative bacteria also play a role in PSIs and may be associated with systemic illness and multisystem organ failure. A high level of suspicion is of paramount importance in early diagnosis of PSIs. Clinical symptoms of PSIs may be subtle and the infection may become apparent only in its late stages. Early diagnosis is the most important prognostic factor for PSIs. Although blood tests (i.e. ESR, CRP, and white blood cell count) and imaging studies (most commonly MRI) can be useful, it must be clear to the clinician that diagnostic modalities, either tissue biopsy or blood cultures, are of the utmost importance for diagnosing PSIs and devising a correct antibiotic therapy. Antibiotic therapy with early bracing (or bed rest) is the most commonly used treatment method for PSIs. Nevertheless, a more aggressive surgical treatment may be required in some patients. The goals of surgical treatment are to help the eradication of the infection, provide an adequate wound closure, and maintain spine column mechanical stability. more...
- Published
- 2012
5. Epidemiological and clinical features of pyogenic spondylodiscitis
- Author
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Fantoni M, ENRICO TRECARICHI, Rossi B, Mazzotta V, Di Giacomo G, La, Nasto, Di Meco E, Pola E, Fantoni, M, Trecarichi, Em, Rossi, B, Mazzotta, V, Nasto, L, DI MECO, E, and Pola, E
- Subjects
Bacteriological Techniques ,Discitis ,Incidence ,Osteomyelitis ,Middle Aged ,Prognosis ,Settore MED/17 - MALATTIE INFETTIVE ,Risk Assessment ,Young Adult ,Predictive Value of Tests ,Risk Factors ,Humans ,Intervertebral Disc ,SPONDYLODISCITIS ,Aged - Abstract
Pyogenic spondylodiscitis (PS) is an uncommon but important infection, that represents 3-5% of all cases of osteomyelitis. The annual incidence in Europe has been estimated to be from 0.4 to 2.4/100,000. A has been reported, with peaks at age less than 20 years and in the group aged 50-70 years. The incidence of PS seems to be increasing in the last years as a result of the higher life expectancy of older patients with chronic debilitating diseases, the rise in the prevalence of immunosuppressed patients, intravenous drug abuse, and the increase in spinal instrumentation and surgery. PS is in most cases a hematogenous infection. Staphylococcus aureus is the most frequent causative microorganism, accounting for about one half of the cases of PS. Gram-negative rods are causative agents in 7-33% of PS cases. Coagulase-negative staphylococci (CoNS) have been reported in 5-16% of cases. Staphylococcus epidermidis is often related to post-operative infections and intracardiac device-related bacteremia. Unremitting back pain, characteristically worsening during the night, is the most common presenting symptom, followed by fever that is present in about one half of the cases. The mortality of PS ranges from 0 to 11%. In a significant number of cases, recrudescence, residual neurological defects or persistent pain may occur. more...
- Published
- 2012
6. Tuberculous spondylodiscitis: epidemiology, clinical features, treatment, and outcome.
- Author
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Trecarichi, E. M., Di Meco, E., Mazzotta, V., and Fantoni, M.
- Abstract
Background: Tuberculous spondylodiscitis (TS) is a rare but serious clinical condition which may lead to severe deformity and early or late neurological complications. Aim: To discuss certain aspects of the approach to TSs, focusing upon epidemiology, diagnosis, and treatment outcome. Materials and Methods: For the purpose of this review, a literature search was performed using the Pubmed database through to 19th October 2011 to identify studies published in the last 20 years, concerned in epidemiological, clinical, diagnostic, and therapeutical aspects of TS in adults. Only studies drafted in English language and reporting case series of more than 20 patients have been included. Results: TS has been reported to accounts for 1-5% of all TB cases, and for about 50% of the cases of articulo-skeletal TB infections. Despite the actual availability of more effective diagnostic tools, early recognition of TS remains difficult and a high index of suspicion is needed due to the chronic nature of the disease and its insidious and variable clinical presentation. A prompt diagnosis is required to improve long term outcome, and a microbiological confirmation is recommended to enable appropriate choice of anti-mycobacterial agents. Surgery has an important role in alleviating pain, correcting deformities and neurological impairment, and restoring function. Conclusions: Further studies are required to assess the appropriate duration of anti-microbial treatment, also in regarding of a combined surgical approach. [ABSTRACT FROM AUTHOR] more...
- Published
- 2012
7. Epidemiological and clinical features of pyogenic spondylodiscitis.
- Author
-
Fantoni, M., Trecarichi, E. M., Rossi, B., Mazzotta, V., Di Giacomo, G., Nasto, L. A., Di Meco, E., and Pola, E.
- Abstract
Pyogenic spondylodiscitis (PS) is an uncommon but important infection, that represents 3-5% of all cases of osteomyelitis. The annual incidence in Europe has been estimated to be from 0.4 to 2.4/100,000. A has been reported, with peaks at age less than 20 years and in the group aged 50-70 years. The incidence of PS seems to be increasing in the last years as a result of the higher life expectancy of older patients with chronic debilitating diseases, the rise in the prevalence of immunosuppressed patients, intravenous drug abuse, and the increase in spinal instrumentation and surgery. PS is in most cases a hematogenous infection. Staphylococcus aureus is the most frequent causative microorganism, accounting for about one half of the cases of PS. Gram-negative rods are causative agents in 7-33% of PS cases. Coagulase-negative staphylococci (CoNS) have been reported in 5-16% of cases. Staphylococcus epidermidis is often related to post-operative infections and intracardiac device-related bacteremia. Unremitting back pain, characteristically worsening during the night, is the most common presenting symptom, followed by fever that is present in about one half of the cases. The mortality of PS ranges from 0 to 11%. In a significant number of cases, recrudescence, residual neurological defects or persistent pain may occur. [ABSTRACT FROM AUTHOR] more...
- Published
- 2012
8. Answer to the Letter to the Editor of S. Huang et al. concerning "New classification for the treatment of pyogenic spondylodiscitis: validation study on a population of 250 patients with a follow-up of 2 years" by Enrico Pola et al. Eur Spine J (2017) doi:10.1007/s00586-017-5043-5.
- Author
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Pola, Enrico, Autore, G., Formica, V., Pambianco, V., Colangelo, D., Cauda, R., Fantoni, M., and Formica, V M
- Subjects
SPONDYLODISCITIS ,SPINE diseases ,THERAPEUTICS ,SPINAL fusion - Published
- 2017
- Full Text
- View/download PDF
9. Minimally invasive surgery for the treatment of thoraco lumbar pyogenic spondylodiscitis: indications and outcomes
- Author
-
E, Pola, V, Pambianco, G, Autore, V, Cipolloni, M, Fantoni, Pola, E, Pambianco, V, Autore, G, Cipolloni, V, and Fantoni, M
- Subjects
Endoscopic drain- age ,Spondylodisciti ,XLIF ,Discitis ,Lumbar Vertebrae ,Percutaneous discectomy ,Spondylodiscitis ,Minimally invasive surgery, Spondylodiscitis, Indi- cations, Percutaneous discectomy, Endoscopic drain- age, XLIF ,Endoscopic drainage ,Indi- cations ,Settore MED/33 - MALATTIE APPARATO LOCOMOTORE ,Indication ,Treatment Outcome ,Minimally invasive surgery ,Humans ,Minimally Invasive Surgical Procedures - Abstract
OBJECTIVE: Pyogenic spondylodiscitls (PS) is a non-specific infection affecting intervertebral disks and adjacent vertebral bodies. Once considered a rare condition in developed countries, the incidence of PS has been increasing alarmingly and still represents a challenge for clinicians and orthopedic surgeons. New minimally invasive techniques have been proposed but the proper indications for these different approaches remain controversial. The aim of this study was to describe the available minimally invasive surgical techniques and to evaluate their proper indications through a review of recent literature.MATERIALS AND METHODS: Over 30 articles of recent scientific literature have been reviewed and analyzed. Studies were searched through the PubMed database using the key words: spondylodiscitis, minimally invasive, and surgical treatment. The most interesting and valid techniques and results have been reported. Despite the exclusion of case reports, all the available studies have been conducted on small groups of patients. Indications for each technique have been reported according to a clinical-radiological classification of PS.RESULTS: Six of the most widely used minimally invasive surgical techniques have been described. High success rates have been reported in terms of preventing the progression of spondylodiscitis into more destructive forms. reduction of time and operative hospitalization, faster pain relief, early mobilization, and achievement of microbiological diagnosis.CONCLUSIONS: The role of minimally invasive surgery in the treatment of PS is rapidly expanding. Reducing surgery-related morbidity in these frail patients is possible and often necessary. However, while more and more new techniques are being proposed, still few clinical data are available. Clinical comparison studies with open traditional surgery should be encouraged, and more attention should be paid to long-term outcomes. For the present. the indications for minimally invasive procedures should, therefore, be evaluated on a case by case basis and on clinical and radiological findings. more...
- Published
- 2019
10. Multidisciplinary management of pyogenic spondylodiscitis: epidemiological and clinical features, prognostic factors and long-term outcomes in 207 patients
- Author
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Roberto Cauda, Francesca Giovannenze, Francesco Taccari, Enrico Pola, Giulio Maccauro, Massimo Fantoni, V. Pambianco, G Autore, Pola, Enrico, Taccari, F., Autore, G., Giovannenze, F., Pambianco, V., Cauda, R., Maccauro, G., and Fantoni, M. more...
- Subjects
Spondylodiscitis ,medicine.medical_specialty ,Multivariate analysis ,Delayed Diagnosis ,Discitis ,Antibiotic therapy ,Orthopedic treatment ,Outcomes ,Prognostic factors ,Surgery ,Orthopedics and Sports Medicine ,Settore MED/17 - MALATTIE INFETTIVE ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Epidemiology ,medicine ,Endocarditis ,Humans ,Retrospective Studies ,Outcome ,030203 arthritis & rheumatology ,Prognostic factor ,Spondylodisciti ,Suppuration ,business.industry ,Incidence (epidemiology) ,Mortality rate ,Length of Stay ,medicine.disease ,Prognosis ,Anti-Bacterial Agents ,Settore MED/33 - MALATTIE APPARATO LOCOMOTORE ,Orthopedic surgery ,Neurosurgery ,spondilodiscite ,business ,piogenica ,030217 neurology & neurosurgery - Abstract
Purpose: Pyogenic spondylodiscitis (PS) is a potentially life-threatening infection burdened by high morbidity rates. Despite the rising incidence, the proper management of PS is still controversial. Aim of this study was to describe the clinical features of PS and to evaluate the prognostic factors and the long-term outcomes of a large population of patients. Methods: 207 cases of PS treated from 2008 to 2016 with a 2-year follow-up were enrolled. Clinical data from each patient were recorded. The primary outcome was the rate of healing without residual disability. Secondary outcomes included length of stay, healing from infection, death, relapse, and residual disability. Binomial logistic regression and multivariate analysis were used to evaluate prognostic factors. Results: Median diagnostic delay was 30 days and the rate of onset neurological impairment was 23.6%. Microbiological diagnosis was established in 155 patients (74.3%) and the median duration of total antibiotic therapy was 148 days. Orthopedic treatment was conservative for 124 patients and surgical in 47 cases. Complete healing without disability was achieved in 142 patients (77.6%). Statistically confirmed negative prognostic factors were: negative microbiological culture, neurologic impairment at diagnosis and underlying endocarditis (p ≤ 0.05). Healing from infection rate was 90.9%, while residual disabilities occurred in 23.5%. Observed mortality rate was 7.8%. Conclusion: The microbiological diagnosis is the main predictive factor for successful treatment. Early diagnosis and multidisciplinary management are also needed to identify underlying aggressive conditions and to avoid neurological complications associated with poorer long-term outcomes. Despite high healing rates, PS may lead to major disabilities still representing a difficult challenge. Graphical abstract: These slides can be retrieved under Electronic Supplementary material. [Figure not available: see fulltext.] more...
- Published
- 2018
11. Medical and surgical treatment of pyogenic spondylodiscitis
- Author
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Pola, E., Logroscino, C. A., Gentiempo, M., Colangelo, D., Mazzotta, V., Di Meco, E., Massimo FANTONI, Pola, E, Logroscino, Ca, Genitiempo, M, Colangelo, D, Mazzotta, V, DI MECO, E, and Fantoni, M
- Subjects
Male ,Discitis ,medical surgical treatment ,Osteomyelitis ,Middle Aged ,Anti-Bacterial Agents ,Settore MED/33 - MALATTIE APPARATO LOCOMOTORE ,Treatment Outcome ,spondylodisciti ,Humans ,Orthopedic Procedures ,spondylodiscitis ,Intervertebral Disc ,Aged - Abstract
BACKGROUND: Pyogenic vertebral osteomyelitis (PVO) represents approximately 2-7% of all cases of osteomyelitis. The approach to the treatment of PVO may be conservative, which includes antibiotic therapy and orthopaedic treatment, or surgical. AIM: To overview conservative and surigical approaches to PVO. METHODS: A literature review was performed using the Pubmed database to identify studies published in the last 20 years, addressing the treatment of PVO. RESULTS: Empirical antibiotic treatment of PVO, while waiting for the results of cultures or in culture-negative cases, should include broad spectrum agents in association with agents active on Staphylococcus (S.) aureus. Based on local epidemiological data, antibiotics active on methicillin resistant S. aureus (MRSA) should be included. Once an organism has been identified, antibiotics should be initially administered intravenously but the optimal duration of antimicrobial therapy is unclear. Studies have reported that the incidence of treatment failure was higher when i.v. therapy was administered for less than 4 weeks. Rifampin is widely used in the combination therapy of PVO, but no controlled trials are available to define weather this approach is beneficial. Many PVO need a surgical treatment and can represent a real challenge for the orthopaedic surgeon. Anterior and posterior cervical, thoracic, lumbar approaches and the relatives surgical strategies are reported in this review. Moreover, recently the mininvasive posterior stabilization have been proposed as a efficient alternative to open surgery in elderly with severe comorbidities. Possible advantages and limitations of this technique are also reported. CONCLUSIONS: Further research is needed in order to define the optimal duration of antibiotic therapy, and the benefits and limitations of open or mini-invasive surgical techniques. more...
- Published
- 2012
12. Pyogenic and Tubercular Spondylodiscitis - Editorial
- Author
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Fantoni, Massimo, Pola, Enrico, Fantoni, M, and Pola, E
- Subjects
spondylodiscitis ,Settore MED/17 - MALATTIE INFETTIVE - Abstract
not available
- Published
- 2012
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