Faundez Antonio A
Service de chirurgie orthopédique et de traumatologie de l'appareil moteur, HUG, 1211 Genève 14.
Rev Med Suisse. 2006 Mar 15;2(57):709-10, 713-4.
Introduction of antibiotics in the last century and recent progress in surgical techniques have significantly reduced mortality and morbidity rates of spondylodiscitis. However, when unrecognized, it can have catastrophic consequences for the patient. Antibiotic drugs remain the cornerstone of treatment, and surgery is to be discussed in general as a last resource in case of acute neurologic deficit or severe sagittal or frontal spinal imbalance. Metallic implants are not absolutely contraindicated in surgical treatment of spondylodiscitis and relapse of infection has been reported to be rare. In case of severe mechanical instability and neurologic deficit, they even are indispensable and complications can be avoided by accurately identifying the germ and by treating infection with the adequate antibiotic beforehand.
上世纪抗生素的引入以及近期手术技术的进步显著降低了脊椎椎间盘炎的死亡率和发病率。然而，如果未被识别，它可能会给患者带来灾难性后果。抗生素药物仍然是治疗的基石，一般而言，在出现急性神经功能缺损或严重矢状面或额状面脊柱失衡的情况下，手术应作为最后的手段进行讨论。金属植入物在脊椎椎间盘炎的手术治疗中并非绝对禁忌，据报道感染复发情况很少见。在存在严重机械性不稳定和神经功能缺损的情况下，它们甚至是不可或缺的，通过准确识别病原体并预先使用适当的抗生素治疗感染，可以避免并发症的发生。
