Petkova Aneta S, Zhelyazkov Christo B, Kitov Borislav D
Department of Neurosurgery, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
Clinic of Neurosurgery, St. George University Hospital, Plovdiv, Bulgaria
Folia Med (Plovdiv). 2017 Sep 1;59(3):254-260. doi: 10.1515/folmed-2017-0024.
Spontaneous spondylodiscitis is a rare but serious infectious disease which is a combination of an inflammatory process, involving one or more adjacent vertebral bodies (spondylitis), the intervertebral discs (discitis) and finally - the neighboring neural structures. In most cases the condition is due to a hematogenous infection and can affect all regions of the spinal cord, but it is usually localized in the lumbar area. The most common clinical symptom is a pronounced, constant and increasing nocturnal paravertebral pain, while consequently different degrees of residual neurological symptoms from nerve roots and/or spinal cord may appear. The disease course is chronic and the lack of specific symptoms often prolongs the time between its debut and the diagnosis. This delay in diagnosis determines its potentially high morbidity and mortality. Treatment is conservative in cases with no residual neurological symptoms and consists of antibiotic therapy and immobilization. Surgical treatment is necessary in patients with neurological deficit, spinal instability or drug resistance.
自发性脊椎椎间盘炎是一种罕见但严重的感染性疾病，它是一种炎症过程，涉及一个或多个相邻椎体（脊柱炎）、椎间盘（椎间盘炎），最终还会累及邻近的神经结构。在大多数情况下，该病是由血源性感染引起的，可影响脊髓的所有区域，但通常局限于腰部。最常见的临床症状是明显、持续且逐渐加重的夜间椎旁疼痛，随后可能会出现不同程度的来自神经根和/或脊髓的残余神经症状。病程是慢性的，缺乏特异性症状常常会延长疾病初发与诊断之间的时间。这种诊断延迟决定了其潜在的高发病率和死亡率。对于没有残余神经症状的病例，治疗是保守的，包括抗生素治疗和固定。对于有神经功能缺损、脊柱不稳定或耐药的患者，手术治疗是必要的。
