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[腰椎间盘手术后的脊椎椎间盘炎。临床方面——诊断——治疗]

[Spondylodiscitis following lumbar intervertebral disk surgery. Clinical aspects--diagnosis--therapy].

作者信息

Frank A M, Trappe A E

机构信息

Neurochirurgische Abteilung, Technischen Universität München.

出版信息

Neurochirurgia (Stuttg). 1988 Nov;31(6):205-9. doi: 10.1055/s-2008-1053937.

Abstract

From 1980 to 1986 6632 operations of the lumbar spine due to disc prolapse were carried out by the Department of Neurosurgery of the hospital of the Technical University of Munich. During this period we saw 14 cases of postoperative spondylodiscitis. Patients' main symptom was increasing low back pain. Physical examination showed difficulty in forward flexion of the body. The blood sedimentation rate was always examined: an average increase to 42/66 mm was recorded. X-ray examination of the lumbar spine and magnetic resonance imaging proved to be the most sensitive methods of investigation, better than scintigram and computed tomography. Our therapeutic management consists of fixation in normal position with a "Light Cast" corset and additional antibiotic therapy with cephadroxil. In comparison to other therapy methods, i.e. restcure, the advantage for our patients is that they can stay at home and move about. Therapy must be continued until the blood sedimentation rate is normal and radiological signs of consolidation can be seen for at least over 10 weeks. Good long-term results were seen in all patients.

摘要

1980年至1986年期间,慕尼黑工业大学医院神经外科开展了6632例因椎间盘突出症而进行的腰椎手术。在此期间,我们共发现14例术后脊椎椎间盘炎患者。患者的主要症状是腰痛加剧。体格检查显示身体前屈困难。总是会检查血沉:平均升至42/66毫米。腰椎X线检查和磁共振成像被证明是最敏感的检查方法,比闪烁扫描和计算机断层扫描更好。我们的治疗方法包括使用“轻质石膏”束腹带固定于正常体位,并加用头孢羟氨苄进行抗生素治疗。与其他治疗方法(即卧床疗养)相比,对我们的患者来说,优势在于他们可以待在家里并四处活动。治疗必须持续到血沉正常且至少在10周以上能看到影像学上的愈合迹象。所有患者均获得了良好的长期效果。

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