Publications by authors named "Miquel Iborra"

2 Publications

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Intervention to reduce the incidence of surgical site infection in spine surgery.

Am J Infect Control 2020 05 7;48(5):550-554. Epub 2019 Nov 7.

Faculty of Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain; Preventive Medicine Department, Germans Trias i Pujol University Hospital, Badalona, Spain.

Background: This study examines the incidence, characteristics, and risk factors of surgical site infections (SSIs) after spine surgery and evaluates the efficacy of a preventive intervention.

Methods: This was a quasi-experimental pretest/posttest study in patients undergoing spinal surgery in an orthopedic surgery department from December 2014 to November 2016. Based on the results of the study, we revised the preventive protocol with modification of wound dressing, staff training, and feedback. SSI rates were compared between the pre-intervention (December 2014 to November 2015) and post-intervention (December 2015 to November 2016) periods. The risk factors were analyzed using univariate and multivariate analyses.

Results: Of the 139 patients included, 14 cases of SSI were diagnosed, with a significant decrease in the incidence of SSIs from the pre-intervention period to the post-intervention period (19.4% vs 2.6%; P = .001). The etiology was known in 13 cases, with enteric flora being predominant in the pre-intervention group. Univariate analysis showed that age, body mass index, days until sitting and ambulation, and incontinence were statistically significant risk factors. After multivariate analysis, only body mass index and days until ambulation remained significant. When the effect of intervention was adjusted with other risk factors, this variable remained statistically significant.

Conclusions: An intervention that includes modification of wound dressing and early mobilization, as well as staff awareness training, monitoring, and feedback, allowed a significant reduction in the incidence of SSI following spinal surgery, particularly infections caused by enteric flora.
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http://dx.doi.org/10.1016/j.ajic.2019.09.007DOI Listing
May 2020

Value of bone SPECT-CT to predict chronic pain relief after percutaneous vertebroplasty in vertebral fractures.

Spine J 2011 Dec;11(12):1102-7

Department of Nuclear Medicine, Hospital Universitari Germans Trias i Pujol. Carretera del Canyet, Badalona, Barcelona, Spain.

Background Context: Longer life span has resulted in increased risk of vertebral osteoporotic fractures. Among minimally invasive procedures, percutaneous vertebroplasty (PV) has shown excellent results in the treatment of chronic vertebral pain. The role of preintervention bone single photon emission computed tomography-computed tomography (SPECT-CT) has not been clearly established for the management of these patients.

Purpose: To determine the value of bone SPECT-CT in patient selection, treatment planning, and prediction of response to PV. A comparison with magnetic resonance imaging (MRI) was also aimed.

Study Design: Prospective consecutive series.

Patient Sample: We studied the performance of bone SPECT-CT on 33 consecutive patients with chronic pain because of vertebral fracture intended for PV.

Outcome Measures: Improvement of clinical status was based on comparison of preprocedure and postprocedure outcome measurements of pain, mobility, and analgesic use.

Methods: Bone SPECT was done using a dual-detector variable-angle gamma camera coupled with a two-slice CT scanner (Symbia T2 System; Siemens, Munich, Germany). Magnetic resonance imaging was done using a magnet of 1.5 T (Giroscan System ACS NT Intera; Philips, Amsterdam, The Netherlands).

Results: Of the 33 patients, 24 finally underwent PV. Positive SPECT-CT images predicted clinical improvement in 91% (21 of 23) of them. Agreement between SPECT-CT and MRI was 80% (20 of 25). Single photon emission computed tomography-computed tomography images showed an alternative cause of pain in some cases, such as new fractures or multiple coexisting fractures, persisting bone remodeling in a previous cemented vertebra, and facet or discal degenerative disease. Single photon emission computed tomography-computed tomography was mandatory in eight patients that could no receive MRI, all of whom improved after PV.

Conclusions: Positive bone SPECT-CT seems a good predictor of postprocedural response. It also adds valuable information as to the cause of back pain and facilitates complete patient evaluation in patients that can not receive MRI.
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http://dx.doi.org/10.1016/j.spinee.2011.11.003DOI Listing
December 2011