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计算机断层扫描引导下对疑似脊椎椎间盘炎进行活检:单中心经验,包括201例活检操作。

Computed-tomography-guided biopsy in suspected spondylodiscitis: Single-center experience including 201 biopsy procedures.

作者信息

Özmen Derya, Özkan Neriman, Guberina Nika, Fliessbach Klaus, Suntharalingam Saravanabavaan, Theysohn Jens, Büchter Matthias, Forsting Michael, Buer Jan, Dudda Marcel, Jäger Marcus, Wetter Axel

机构信息

Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen.

Department of Neurosurgery, University Hospital Essen.

出版信息

Orthop Rev (Pavia). 2019 Mar 22;11(1):7793. doi: 10.4081/or.2019.7793. eCollection 2019 Feb 26.

Abstract

Our propose is to evaluate CT-guided biopsies in suspected spondylodiscitis with respect to puncture site, microbiology findings, histopathology findings and impact on antibiotic therapy. 86 CT-guided spine interventions in suspected spondylodiscitis comprising 201 biopsy procedures were analyzed. Medical records of all patients were screened for microbiology and histopathology reports as well as date, duration and kind of antibiotic therapy. Statistical analyses included calculation of Chi-tests and logistic regression analyses. Locations of biopsies were intervertebral disc (48.3%), paravertebral soft-tissue (38.3%) and vertebral body (10.9%). Positive microbiological findings were found altogether in 33.8% of cases, positive histopathological findings in 53.6%. Significant associations between positive microbiological findings, positive histopathological findings and antibiotic therapy, respectively, were found. Location of biopsies did not significantly influence rate of positive findings. From the variables age, white blood cell count, serum creatinine and puncture site, none were found to be an independent predictor for a positive microbiological result. We concluded that CT-guided biopsy of intervertebral disc and paravertebral soft tissue yields positive microbiologic findings in a significant proportion of cases. Puncture site is not associated with positive results of microbiology or histopathology.

摘要

我们的目的是评估在疑似脊椎椎间盘炎中CT引导下活检在穿刺部位、微生物学结果、组织病理学结果以及对抗生素治疗的影响方面的情况。对86例疑似脊椎椎间盘炎的CT引导下脊柱介入手术(包括201次活检操作)进行了分析。筛查了所有患者的病历,以获取微生物学和组织病理学报告以及抗生素治疗的日期、持续时间和类型。统计分析包括卡方检验和逻辑回归分析。活检部位为椎间盘(48.3%)、椎旁软组织(38.3%)和椎体(10.9%)。微生物学阳性结果共在33.8%的病例中发现,组织病理学阳性结果在53.6%的病例中发现。分别发现微生物学阳性结果、组织病理学阳性结果与抗生素治疗之间存在显著关联。活检部位对阳性结果率没有显著影响。在年龄、白细胞计数、血清肌酐和穿刺部位这些变量中,没有一个被发现是微生物学阳性结果的独立预测因素。我们得出结论,CT引导下对椎间盘和椎旁软组织进行活检在相当比例的病例中能获得微生物学阳性结果。穿刺部位与微生物学或组织病理学的阳性结果无关。

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