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使用术中细胞学检查和外固定治疗一只患有播散性感染犬的腰椎 spp. 椎间盘炎的诊断与管理

Diagnosis and management of lumbar spp. discospondylitis using intraoperative cytology and external stabilization in a dog with disseminated infection.

作者信息

Brocal Josep, Del Río Fernando Ribas, Feliu-Pascual Alejandro Luján

机构信息

WEAR REFERRALS Veterinary Hospital, Stockton-on-Tees TS21 2ES, UK.

CV San Jorge, Luisa Oliver, Sant Jordi, Eivissa 07817, Spain.

出版信息

Open Vet J. 2019 Oct;9(3):185-189. doi: 10.4314/ovj.v9i3.1. Epub 2019 Jul 7.

Abstract

BACKGROUND

Discospondylitis is an infection of the intervertebral disc and adjacent vertebral endplates. The infectious agent is most commonly a bacterial organism and fungal causes are uncommon.

CASE DESCRIPTION

A 1.5-year-old female entire pug was referred with a 6-week history of right head tilt and progressive non-ambulatory paraparesis. On neurological examination, right facial paralysis and mid and caudal lumbar pain were also detected. Magnetic resonance imaging and computed tomography of the head and spine were performed 3 weeks apart. Findings were consistent with osteolysis of the petrous temporal bone and L2-L3 and L5-L6 vertebral subluxation caused by discospondylitis and osteomyelitis. Disseminated aspergillosis was diagnosed following biopsy and stabilization using an external skeletal spinal fixator. Voriconazol was administered as a medical treatment after surgery. The dog died 3 months later without failure of the construct.

CONCLUSION

To the authors' knowledge, this is the first report using an external fixator for fungal lumbar discospondylitis. The use of an external skeletal spinal fixator should be considered when choosing the surgical technique.

摘要

背景

椎间盘炎是椎间盘及相邻椎体终板的感染。感染病原体最常见的是细菌,真菌性病因较为罕见。

病例描述

一只1.5岁的未绝育雌性哈巴狗因有6周的右头倾斜和进行性非行走性双下肢轻瘫病史而被转诊。神经学检查还发现右侧面神经麻痹以及腰中部和尾部疼痛。头部和脊柱的磁共振成像和计算机断层扫描在相隔3周时进行。检查结果与由椎间盘炎和骨髓炎引起的岩颞骨骨质溶解以及L2 - L3和L5 - L6椎体半脱位一致。活检后诊断为播散性曲霉菌病,并使用外部骨骼脊柱固定器进行固定。术后给予伏立康唑进行药物治疗。这只狗在3个月后死亡,固定装置未失效。

结论

据作者所知,这是第一例使用外部固定器治疗真菌性腰椎间盘炎的报告。在选择手术技术时应考虑使用外部骨骼脊柱固定器。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e251/6794401/11fc8cb6e322/OpenVetJ-9-185-g001.jpg

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