Zhu Xiao-Long, Xu Wei-Xin, Liu Jie
Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang, China;
Zhongguo Gu Shang. 2016 Sep 25;29(9):870-874. doi: 10.3969/j.issn.1003-0034.2016.09.020.
As the disc surgery were extensively developed, the incidence of intervertebral space infection was significantly increased. Due to a lack of specificity, early diagnosis is difficult and it is prone to misdiagnose. Intervertebral disc puncture sampling microorganism culture is a gold standard of antibiotic selection, but the positive detection rate needs to be improved. At present, different medical institutions have different opinious in epidemiology, treatment experiences, the choice of antibiotic treatment, the course of treatment and the way of operation. In recent years, magnetic resonance imaging, fluorine deoxidization glucose positron emission computed tomography scanning, the imaging application mediated percutaneous intervertebral disc, spinal puncture percutaneous endoscopic debridement and lavage drainage and percutaneous internal fixation combined with anterior posterior incision provide more choices for early diagnosis and treatment. Intervertebral infection should attract more attention to the prevention, early diagnosis, early specific pathogens. Doctors' experience and patients' actual situation should be considered when choosing a appropriate treatment. During the treatment, we should be closely monitored laboratory indexes and timely adjust plan of the treatment, and shorten the treatment time and prevent other complications through the auxiliary treatment.
随着椎间盘手术的广泛开展，椎间隙感染的发生率显著增加。由于缺乏特异性，早期诊断困难且易于误诊。椎间盘穿刺取样微生物培养是抗生素选择的金标准，但阳性检出率有待提高。目前，不同医疗机构在流行病学、治疗经验、抗生素治疗选择、疗程及手术方式等方面存在不同观点。近年来，磁共振成像、氟脱氧葡萄糖正电子发射断层扫描、影像介导经皮椎间盘穿刺、经皮内镜下清创冲洗引流及经皮内固定联合前后路切开等为早期诊断和治疗提供了更多选择。椎间感染应更加重视预防、早期诊断及明确病原体。选择合适的治疗方法时应考虑医生经验及患者实际情况。治疗过程中，应密切监测实验室指标，及时调整治疗方案，通过辅助治疗缩短治疗时间并预防其他并发症。
