Department of Orthopaedics, Zhongshan Hospital Affiliated to Fudan University, Shanghai, China.
Orthop Surg. 2011 Aug;3(3):152-7. doi: 10.1111/j.1757-7861.2011.00140.x.
Postoperative infection is the commonest complication that causes failure of spinal surgery. Although the rate of infection after cervical surgery is lower than that after lumbar surgery, the absolute number of cases is increasing. In recent years, new techniques, such as serum amyloid A and fludeoxyglucose ((18) F) positron emission tomography (18F-FDG PET), have emerged and gradually been employed in the diagnosis of postoperative infection, updating the ability to identify the presence of infection. Most patients with cervical postoperative infection require re-operation. There are three principles for such surgery: thorough debridement, adequate drainage and ensuring stability of the spine. Some severe cases even need emergency surgery. This article aims to discuss the controversial issues in diagnosis and treatment of cervical postoperative infection, as well as progress in related studies.
术后感染是导致脊柱手术失败的最常见并发症。虽然颈椎手术后感染的发生率低于腰椎手术后感染,但绝对病例数却在不断增加。近年来,一些新技术,如血清淀粉样蛋白 A 和氟脱氧葡萄糖((18)F)正电子发射断层扫描(18F-FDG PET),逐渐应用于术后感染的诊断,提高了识别感染存在的能力。大多数颈椎术后感染患者需要再次手术。此类手术有三个原则:彻底清创、充分引流和确保脊柱稳定性。一些严重的病例甚至需要紧急手术。本文旨在讨论颈椎术后感染诊断和治疗中的一些争议问题,以及相关研究的进展。