Machida Hideto
Kanto Rosai Hospital, Department of Orthopedic Surgery.
Clin Calcium. 2008 May;18(5):685-90.
Historically, pyogenic vertebral osteomyelitis was disease with high morbidity and mortality rate. In recent years, with advance of new diagnostic techniques, antimicrobial chemotherapy, and improvement in surgical techniques, the prognosis has improved dramatically. However, as a recent tendency, the number of patients tends to increase by aging of the patient, increase of immuno-compromised host and resistant bacteria. There is a case the spine infection with immuno-compromised host sometimes accompanies sepsis and to die. Therefore, the management of this disease has still many pitfalls and problems. An early diagnosis is necessary, and identification of causative organism and appropriate antimicrobial chemotherapy are basics of treatment. But when indicated, we should cooperate with a spinal surgeon closely, and choose surgical intervention.
从历史上看，化脓性脊椎骨髓炎是一种发病率和死亡率都很高的疾病。近年来，随着新诊断技术、抗微生物化疗的进展以及手术技术的改进，预后有了显著改善。然而，作为一种近期趋势，患者数量因患者老龄化、免疫功能低下宿主数量增加以及耐药菌的出现而呈上升趋势。有免疫功能低下宿主的脊柱感染有时会并发败血症并导致死亡的病例。因此，这种疾病的治疗仍存在许多陷阱和问题。早期诊断是必要的，确定病原体和进行适当的抗微生物化疗是治疗的基础。但在有指征时，我们应与脊柱外科医生密切合作，并选择手术干预。
