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[化脓性脊椎椎间盘炎:治疗方案及治疗决策的新分类]

[Pyogenic spondylodiscitis: therapy algorithm and a new classification for therapeutic decision-making].

作者信息

Akbar M, Sobottke R, Lehner B, Eichler M, Wang H, Carstens C, Wiedenhöfer B

机构信息

Department Orthopädie, Unfallchirurgie und Paraplegiologie, Zentrum für Wirbelsäulenchirurgie, Stiftung Orthopädische Universitätsklinik Heidelberg, Heidelberg, Deutschland.

出版信息

Orthopade. 2012 Sep;41(9):749-58. doi: 10.1007/s00132-012-1998-4.

Abstract

The incidence of pyogenic spondylodiscitis is low but has been steadily increasing in recent years. To date there has been no consensus concerning selection of the appropriate treatment, management and strategies and the recommendations for an operative strategy are still a highly controversial issue. In the literature a few statements have been published concerning therapeutic decision-making in pyogenic spondylodiscitis. The classification given in this article is based on clinical experience and retrospective data analysis considering the degree of segmental bony destruction, grade of kyphosis and instability, epidural involvement of the disease and neurological deficits, which are pivotal for therapeutic decision-making. The therapeutic procedure can be defined based on this classification.

摘要

化脓性脊椎椎间盘炎的发病率较低,但近年来呈稳步上升趋势。迄今为止,关于选择合适的治疗方法、管理措施和策略尚未达成共识,手术策略的建议仍然是一个极具争议的问题。在文献中,已经发表了一些关于化脓性脊椎椎间盘炎治疗决策的论述。本文给出的分类是基于临床经验和回顾性数据分析,考虑节段性骨质破坏程度、后凸畸形和不稳定程度、疾病的硬膜外受累情况以及神经功能缺损,这些对于治疗决策至关重要。可以基于此分类来确定治疗方法。

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