Asamoto Shunji, Doi Hiroshi, Kobayashi Nobusuke, Endoh Takahiro, Sakagawa Hajime, Iwanaga Yoichi, Ida Masahiro, Jinbo Hiroyuki
Department of Neurosurgery, Tokyo Metropolitan Ebara Hospital, 1450065 Tokyo, Japan.
Surg Neurol. 2005 Aug;64(2):103-8; discussion 108. doi: 10.1016/j.surneu.2004.11.034.
We present our experience in the diagnosis and treatment of spondylodiscitis.
27 patients with spondylodiscitis were studied. There were 15 men and 12 women, with ages ranging from 26 to 85 years. Of the 27 cases, there were 21 patients with pyogenic spondylodiscitis, 6 patients with tuberculosis spondylodiscitis, and 8 patients with diabetes mellitus complication. Two patients presented with tetraparesis, 13 with paraparesis, and 1 with hemiparesis. Seventeen patients underwent surgical treatment, among whom surgical intervention with instrumentation was performed on 5 patients, and emergency operation was performed on 6 patients.
Fourteen patients were judged as "excellent," 8 patients as "good," and 4 patients as "no change." One patient died because of infection by penicillin-resistant Staphylococcus pneumoniae.
It is very difficult to diagnose spondylodiscitis at the first medical examination. Most spondylodiscitis patients often first visit a department of internal medicine. We strongly recommend that all doctors, especially doctors examining diabetes mellitus patients daily, should be well informed of spondylodiscitis in order to improve its diagnosis.
我们介绍了在诊断和治疗脊椎椎间盘炎方面的经验。
对27例脊椎椎间盘炎患者进行了研究。其中男性15例，女性12例，年龄在26至85岁之间。27例病例中，有21例为化脓性脊椎椎间盘炎患者，6例为结核性脊椎椎间盘炎患者，8例为糖尿病并发症患者。2例患者出现四肢轻瘫，13例出现截瘫，1例出现偏瘫。17例患者接受了手术治疗，其中5例患者进行了器械辅助手术干预，6例患者进行了急诊手术。
14例患者被判定为“优秀”，8例患者为“良好”，4例患者为“无变化”。1例患者因耐青霉素肺炎链球菌感染死亡。
在首次医学检查时很难诊断出脊椎椎间盘炎。大多数脊椎椎间盘炎患者通常首先就诊于内科。我们强烈建议所有医生，尤其是每天检查糖尿病患者的医生，应充分了解脊椎椎间盘炎以便改善其诊断。
