Boston H C, Bianco A J, Rhodes K H
Orthop Clin North Am. 1975 Oct;6(4):953-64.
The present review of disk space infection in children agrees with that carried out in 1962.12 The physician who encounters a child with back or hip pain, irritability, and a change in walking pattern should always suspect an infection of the vertebral column, particularly in the presence of limited spine motion, spasm, and an elevated sedimentation rate. S. aureus still is the usual primary infecting agent. Treatment consisting of rigid immobilization of the spinal column during the acutely painful phase appears to be adequate therapy. The use of antibiotics is not generally recommended. Because of this, hospitalization is usually not prolonged unneccessarily. The rationable for the use of antibiotics in one atypical case included recurrence of clinical signs and symptoms despite immobilization. These included persistent pain and spasm associated with a high sedimentation rate. Disk space aspiration probably is no longer necessary or desirable in the usual patient in whom immobilization is generally effective. The prognosis for most patients is good. Occasionally spinal fusion should be considered in this young age group if mechanical backache persists after the infection has been cured. The findings and recommendations regarding management of this disease in children should not be applied to the adult.
目前对儿童椎间盘间隙感染的综述与1962年进行的综述一致。遇到有背部或髋部疼痛、易怒以及行走模式改变的儿童的医生，应始终怀疑有脊柱感染，尤其是在存在脊柱活动受限、痉挛和血沉升高的情况下。金黄色葡萄球菌仍然是常见的主要感染病原体。在急性疼痛阶段对脊柱进行严格固定的治疗似乎是足够的疗法。一般不建议使用抗生素。因此，住院时间通常不会不必要地延长。在一个非典型病例中使用抗生素的理由包括尽管进行了固定，但临床体征和症状仍复发。这些包括与高血沉率相关的持续疼痛和痉挛。对于固定通常有效的普通患者，椎间盘穿刺可能不再必要或可取。大多数患者的预后良好。如果感染治愈后机械性背痛持续存在，偶尔在这个年轻年龄组中应考虑进行脊柱融合术。关于儿童这种疾病管理的研究结果和建议不适用于成人。
