Verdú-López F, Vanaclocha-Vanaclocha V, Gozalbes-Esterelles L, Sánchez-Pardo M
Department of Neurosurgery Consorcio Hospital General Universitario de Valencia Valencia, Spain -
J Neurosurg Sci. 2014 Jun;58(2):45-56.
Infections of the spine have been a constant throughout history. At present there are infections in the spine fostered in part by the same advances in medicine: there are a lot of immunocompromised patients, the life expectancy of patients with chronic diseases is augmented and the increasing number of complex spinal surgeries can result in secondary infection. In this review the main types of infection of the spine and its treatment highlighting techniques in minimally invasive surgery are discussed. Spontaneous pyogenic and nonpyogenic spine infections as well as iatrogenic infections can be treated in a different manner depending on its extension, location and microorganism involved. We will review the use and the indication of percutaneous image-guided techniques, endoscopic and microsurgical techniques with or without use of tubular retractors. We conclude that techniques in minimally invasive surgery in spine infections are safe, effective and have benefits in morbidity of the approach and subsequent patient recovery.
脊柱感染在历史上一直存在。目前,脊柱感染部分是由医学的同样进步所引发的:存在许多免疫功能低下的患者,慢性病患者的预期寿命延长,以及越来越多的复杂脊柱手术会导致继发性感染。在这篇综述中,讨论了脊柱感染的主要类型及其治疗方法,重点介绍了微创手术技术。自发性化脓性和非化脓性脊柱感染以及医源性感染可根据其范围、位置和所涉及的微生物以不同方式进行治疗。我们将回顾经皮影像引导技术、内镜和显微手术技术(无论是否使用管状牵开器)的使用和适应证。我们得出结论,脊柱感染的微创手术技术是安全、有效的,并且在手术入路的发病率和患者随后的恢复方面具有益处。