Rajamaheswari N, Agarwal Sugandha, Seethalakshmi Krishnan
Department of Urogynecology, Government Kasturba Gandhi Hospital and Institute of Social Obstetrics, Madras Medical College, Triplicane, Chennai 05, India.
Int Urogynecol J. 2012 Mar;23(3):375-7. doi: 10.1007/s00192-011-1547-4. Epub 2011 Sep 2.
Lumbosacral spondylodiscitis, an unusual complication of abdominal sacrocolpopexy using synthetic polypropylene mesh is reported. A young sexually active female with stage IV pelvic organ prolapse was managed with abdominal hysterectomy and sacrocolpopexy. Cervical dysplasia demanded hysterectomy and sacrocolpopexy was done to achieve good long-term results. Mesh exposure was noticed in the early post-operative period which initially responded to conservative management. Eight weeks later, the patient reported with severe pain in lower back restricting her physical movements and ambulation. Further evaluation with magnetic resonance imaging (MRI) confirmed lumbosacral spondylodiscitis, due to the infected mesh which warranted a complete removal of mesh by laparotomy. Removal of the mesh completely relieved her symptoms. Repeat MRI revealed resolving spondylodiscitis. The removal of mesh by itself was adequate to relieve her and discectomy was not required. The vault remained well supported despite removal of mesh.
据报道，腰骶部脊椎椎间盘炎是使用合成聚丙烯网片进行腹式骶骨阴道固定术的一种罕见并发症。一名患有IV期盆腔器官脱垂的年轻性活跃女性接受了腹式子宫切除术和骶骨阴道固定术。宫颈发育异常需要进行子宫切除术，为获得良好的长期效果而实施了骶骨阴道固定术。术后早期发现网片暴露，最初对保守治疗有反应。八周后，患者报告下背部剧痛，限制了她的身体活动和行走。通过磁共振成像（MRI）进一步评估证实为腰骶部脊椎椎间盘炎，原因是网片感染，这需要通过剖腹手术完全移除网片。移除网片完全缓解了她的症状。重复MRI显示脊椎椎间盘炎正在消退。仅移除网片就足以缓解她的症状，无需进行椎间盘切除术。尽管移除了网片，但穹窿仍得到良好支撑。
