Krödel A, Stürz H
Orthopädischer Klinik, Ludwig-Maximilians-Universität München Klinikum, Grosshadern.
Z Orthop Ihre Grenzgeb. 1989 Sep-Oct;127(5):587-96. doi: 10.1055/s-2008-1040296.
In the time from 1980 to 1987 58 patients underwent a conservative or operative treatment of spondylitis and spondylodiscitis according to the individual clinical and radiological features. In early or moderately advanced stages of the disease conservative therapy was performed. Under bedrest and antibacterial or tuberculostatic drug therapy bony fusion of the affected vertebral bodies was achieved in 50% of the pyogenic cases. In tuberculous spondylitis fusion rate was 83%. Persistent septic changes, progressive neurological symptoms and gross vertebral damage are indications for surgery. In those cases removal of the focus and intercorporal spondylodesis was performed. Bony union occurred in every cases. At follow-up examination, 3 years after the onset of therapy on an average, 42 patients had no complaints according to the vertebral column. As the results of our study show spondylitis and spondylodiscitis should according to the clinical and radiological features be lead to a differentiated operative or conservative treatment. Then good clinical results are to be supposed.
在1980年至1987年期间，58例患者根据个体临床和放射学特征接受了脊柱炎和脊椎椎间盘炎的保守或手术治疗。在疾病的早期或中度进展阶段，采用保守治疗。在卧床休息以及抗菌或抗结核药物治疗下，50%的化脓性病例实现了受累椎体的骨融合。在结核性脊柱炎中，融合率为83%。持续的感染性改变、进行性神经症状和严重的椎体损伤是手术指征。在这些病例中，进行了病灶清除和椎体间融合术。所有病例均实现了骨愈合。在平均治疗开始3年后的随访检查中，42例患者脊柱无不适主诉。正如我们的研究结果所示，脊柱炎和脊椎椎间盘炎应根据临床和放射学特征进行差异化的手术或保守治疗。这样有望获得良好的临床效果。
