Orthopaedic Clinic University of Modena, Modena, Italy.
Eur Spine J. 1993 Mar;1(4):226-30. doi: 10.1007/BF00298364.
We analysed 13 cases of lumbar disc infection following surgical discectomy. Two groups of patients were identified. The six patients in group A reported that the initial symptoms of discitis had appeared a mean of 15 days after surgery; on average, antibiotic treatment was started 31 days following operation and continued for 62 days, and symptoms regressed after 3.9 months. Four patients showed moderate changes, while two had extensive osteolytic lesions of one or both vertebral bodies adjacent to the involved disc. In the 7 cases in group B, discitis was suspected a mean of 5 days and antibiotics were initiated a mean of 8 days following surgery; on average, symptoms regressed 1.8 months after operation. Only four patients showed vertebral radiographic changes and none had marked destructive lesions. In both groups erythrocyte sedimentation rate exceeded 70 mm/h in cases in which discitis was suspected. Tomograms and magnetic resonance studies were the most diagnostic imaging studies in the initial stages of the disease. All patients obtained satisfactory clinical results at the last follow-up. Careful observation of the early postoperative clinical course usually allows detection of disc space infection. Early and adequately prolonged antibiotic treatment may shorten the course of the disease and avoid extensive osteolytic vertebral lesions.
我们分析了 13 例腰椎间盘感染病例，这些病例均继发于手术椎间盘切除术后。将患者分为两组。A 组的 6 例患者报告称，术后出现椎间盘炎的初始症状的平均时间为 15 天；平均而言，术后 31 天开始使用抗生素治疗，持续 62 天，症状在 3.9 个月后消退。4 例患者表现为中度变化，而 2 例患者相邻椎间盘受累的一个或两个椎体均有广泛的溶骨性病变。B 组的 7 例患者中，椎间盘炎的平均可疑时间为 5 天，平均在手术后 8 天开始使用抗生素；平均而言，症状在术后 1.8 个月消退。只有 4 例患者出现脊柱影像学改变，无一例患者有明显的破坏性病变。在怀疑椎间盘炎的病例中，两组的红细胞沉降率均超过 70mm/h。在疾病的初始阶段，断层扫描和磁共振研究是最具诊断意义的影像学研究。所有患者在最后一次随访时均获得了满意的临床结果。仔细观察术后早期的临床病程通常可以发现椎间盘间隙感染。早期和充分延长的抗生素治疗可能会缩短病程并避免广泛的溶骨性椎体病变。
