Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK.
Eur Spine J. 1993 Oct;2(3):145-8. doi: 10.1007/BF00301412.
The incidence of discitis following discectomy is reported at between 0.75% and 3.0%. We believe this rate could be reduced if an antibiotic that penetrated the disc tissue with an appropriate spectrum were to be given prophylactically to cover surgery. A prospective study of 20 patients undergoing routine lumbar discectomy was performed. Ten patients received Augmentin 1.2 g and ten received cefuroxime 1.5 g pre-operatively. In eight patients sequestrated disc fragments were analysed, and the majority were found to have drug levels higher than in the attached disc material; the reasons for this are discussed. We conclude that Augmentin penetrates damaged disc material to a limited extent, but cefuroxime achieves levels effective against the most commonly implicated pathogens in discitis tissue and is a rational choice of antibiotic for prophylaxis during lumbar discectomy.
术后椎间盘炎的发病率据报道在 0.75%至 3.0%之间。我们认为，如果在手术预防性使用一种能穿透椎间盘组织、具有适当谱的抗生素，这种发病率是可以降低的。对 20 例行常规腰椎间盘切除术的患者进行了前瞻性研究。10 例患者术前接受了 1.2 g 的 Augmentin，10 例患者接受了 1.5 g 的头孢呋辛。对 8 例椎间盘碎片进行了分析，大多数发现药物水平高于附着的椎间盘组织；讨论了造成这种情况的原因。我们得出结论，Augmentin 能有限地穿透受损的椎间盘组织，但头孢呋辛能达到针对椎间盘炎组织中最常见的病原体的有效水平，是腰椎间盘切除术中预防使用的合理抗生素选择。
