Fica Alberto, Bozán Francisca, Aristegui Magdalena, Bustos Patricio
Sección de Infectología, Departamento de Medicina y Departamento de Neurología y Neurocirugía, Hospital Clínico Universidad de Chile, Av. Santos Dumont 999, Independencia, Santiago.
Rev Med Chil. 2003 May;131(5):473-82.
Spondylodiscitis is a rare but prolonged inflammation of two adjacent vertebral bodies and the disk in between.
To report the clinical features of a series of patients with spondylodiscitis.
A retrospective analysis of medical records of patients with spondylitis, identified between 1989 and 2002.
A total of 25 cases were identified, 15 female, aged 49.8 years as a mean. Their mean evolution before admission was 4.3 months. Main complaints were back or radicular pain. Mild anemia was present in most patients. Mean erythrocyte sedimentation rate and C reactive protein values were 66 mm/h and 60 mg/L, respectively. Forty four percent of patients had neurological complications. Vertebral computed tomography and scintigraphic studies were done in 72% of patients, but magnetic resonance imaging was done only in 4 (16%). In 18 patients, a tissue sample for pathological and microbiological analysis, was obtained by imaging guiding or surgically. Tuberculosis, diagnosed on pathology, was the leading cause of spondylitis in nine cases (36%), followed by Staphylococcus aureus infection in five (20%). Other agents found were E coli and group D Streptococcus (one each). Age, symptoms, evolution time and different laboratory parameters did not differ between patients with tuberculosis and patients with other causes. A microbiological cause was not established in 36% of cases. Most patients evolved satisfactorily and recovered from neurological complications (88%). One patient with tuberculosis did not improve after prolonged treatment and 2 patients infected with S aureus died (8%).
Spondylodiscitis is associated to a diversity of microbial agents and in most cases has a favorable prognosis.
脊椎椎间盘炎是一种罕见但病程较长的疾病，累及两个相邻椎体及其间的椎间盘。
报告一系列脊椎椎间盘炎患者的临床特征。
对1989年至2002年间确诊的脊椎炎患者病历进行回顾性分析。
共确诊25例，其中女性15例，平均年龄49.8岁。入院前平均病程为4.3个月。主要症状为背痛或神经根性疼痛。多数患者存在轻度贫血。红细胞沉降率和C反应蛋白的平均值分别为66mm/h和60mg/L。44%的患者出现神经并发症。72%的患者进行了脊椎计算机断层扫描和闪烁扫描检查，但仅4例（16%）进行了磁共振成像检查。18例患者通过影像引导或手术获取了用于病理和微生物分析的组织样本。经病理诊断，结核病是9例（36%）脊椎炎的主要病因，其次是金黄色葡萄球菌感染5例（20%）。其他病原体为大肠杆菌和D组链球菌（各1例）。结核病患者与其他病因患者在年龄、症状、病程及不同实验室参数方面无差异。36%的病例未明确微生物病因。多数患者病情进展良好，神经并发症得以恢复（88%）。1例结核病患者经长期治疗无改善，2例金黄色葡萄球菌感染患者死亡（8%）。
脊椎椎间盘炎与多种微生物病原体相关，多数病例预后良好。
