Kow Chien Yew, Chan Patrick, Etherington Greg, Ton Lu, Liew Susan, Cheng Allen C, Rosenfeld Jeffrey V
Department of Neurosurgery, Alfred Hospital.
Department of Orthopaedics, Alfred Hospital.
J Spine Surg. 2016 Sep;2(3):202-209. doi: 10.21037/jss.2016.08.04.
Panspinal infection usually presents with fever, back pain, neurological deficit, and in advanced cases multi-organ failure and septic shock. The choice of treatment for panspinal infection is challenging because these patients are usually medically unstable with severe neurological compromise. The objective of this study is to review management and long term outcomes for patients with panspinal infection.
A retrospective review of patients with panspinal infection treated in our center over a 5-year period [Jan 2010-Dec 2014] and a review of the current published literatures was undertaken.
We identified 4 patients with panspinal infection. One case was managed medically due to high perioperative risk, whilst the other three were managed surgically whilst on antibiotic therapy. All 3 cases managed surgically improved neurologically and infection subsided, whereas the patient managed medically did not change neurologically and infection subsided.
Patients with panspinal infection should be treated surgically unless the medical risk of surgery or anaesthesia is prohibitive.
全脊柱感染通常表现为发热、背痛、神经功能缺损,在晚期病例中还会出现多器官功能衰竭和感染性休克。全脊柱感染的治疗选择具有挑战性,因为这些患者通常病情不稳定,伴有严重的神经功能损害。本研究的目的是回顾全脊柱感染患者的治疗及长期预后。
对我们中心在5年期间(2010年1月至2014年12月)治疗的全脊柱感染患者进行回顾性研究,并对当前已发表的文献进行综述。
我们确定了4例全脊柱感染患者。1例因围手术期风险高而接受保守治疗,另外3例在抗生素治疗的同时接受了手术治疗。所有3例接受手术治疗的患者神经功能均有改善,感染消退,而接受保守治疗的患者神经功能无变化,感染消退。
全脊柱感染患者应接受手术治疗,除非手术或麻醉的医疗风险过高。