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  • ISSN: 2373-9479
    Early Online
    Volume 6, Issue 1
    Research Article
    Charles H. Crawford, Jeffrey L. Gum, Lawrence G. Lenke, Jacob M Buchowski, Charles C. Edwards, Steven D. Glassman, and Leah Y. Carreon*
    In an effort to reduce the rate of Surgical Site Infections (SSIs), recent studies have reported using intrawound, topical vancomycin powder. Although cost-effective and promising results have been published, there is concern for development of antibiotic resistance and catastrophic superbug infections. The purpose of this study was to evaluate and compare the culture profile of Surgical Site Infection (SSI) in patients undergoing posterior lumbar instrumented fusions with topical vancomycin powder utilized versus controls prior to the use of topical vancomycin powder. Patients who had a posterior lumbar instrumented fusion and subsequently developed SSI requiring operative treatment from June 2007 to June 2008 and from June 2011 to June 2012 were identified. Standard demographic and surgical data were collected. Culture results and timing of the SSI relative to index surgery were also collected. Comparison of SSIs pre-vancomycin (2007-2008) and post-vancomycin (2011-2012) identified 31 versus 26 patients, respectively; no difference in demographic or surgical characteristics between time-dependent cohorts. There was no difference in the culture profile between groups (p=0.667). When comparing the culture profile of surgical site infections after posterior lumbar instrumented fusions, there appears to be no difference comparing a pre-Vancomycin interval versus a post-vancomycin interval. Additionally, comparing SSIs with or without topical vancomycin, regardless of time interval, showed no difference in culture profile. The results of this study suggest that topical vancomycin powder did not increase the incidence of vancomycin-resistant, super bug infections in the time period studied. Continued surveillance of this increasingly common practice is warranted.
    Review Article
    Alberto Gotfryd* and Avanzi O
    Shoulders asymmetry is one of the most notable clinical manifestations in individuals with Adolescent Idiopathic Scoliosis (AIS). Several papers have reported a correlation between shoulders unbalance and patients dissatisfaction. Despite the availability of several clinical and radiographic methods for the evaluation of the shoulders leveling in the current literature, there are still many controversies about how to do it properly. Moreover, the correlation between cosmetic deformity and x-rays images is also questionable and surgeons may be giving excessive attention to radiographic images in detriment to the clinical deformity. The present study aims to highlight the most recent methods for the clinical and radiographic measurements of the shoulder balance, as well as the advantages and limitations of each of them.
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