Scheyerer Max J, Herren Christian, Kühne Christian, Neufang Jörg, Pieroh Philipp, von der Höh Nicolas H
Department of Orthopaedics and Trauma Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Germany.
Clinic for Trauma and Reconstructive Surgery, University Hospital Aachen, Germany.
Z Orthop Unfall. 2022 Dec;160(6):621-628. doi: 10.1055/a-1527-7939. Epub 2021 Aug 30.
Despite advances, the morbidity and mortality rates of patients with spondylodiscitis remains high, with an increasing incidence worldwide. Although conservative therapy has progressed, several cases require surgical intervention. However, the indication and opportunities for surgical treatment are still disputable.
In a joint consensus, the members of the 'Spondylodiscitis' working group of the Spine Section of the German Society for Orthopaedics and Trauma Surgery considered current literature, particularly the newly published S2k guideline of the AWMF, and examined the surgical indications and treatment strategies for thoracolumbar spondylodiscitis.
Surgical intervention for spondylodiscitis is only required in a small percentage of patients. In studies comparing conservative and surgical therapies, most patients benefitted from surgery, regardless of the surgical technique selected. Presently, the standard procedure is a combined dorsoventral approach, in which a monolateral attempt should always be made. The choice of material (PEEK, titanium) for ventral support does not influence the clinical result.
尽管取得了进展，但脊柱椎间盘炎患者的发病率和死亡率仍然很高，且在全球范围内呈上升趋势。虽然保守治疗有所进步，但仍有一些病例需要手术干预。然而，手术治疗的适应症和时机仍存在争议。
德国骨科与创伤外科学会脊柱分会“脊柱椎间盘炎”工作组的成员通过联合共识，参考了当前文献，特别是新近发布的德国医学科学与医学专业协会（AWMF）的S2k指南，并研究了胸腰椎脊柱椎间盘炎的手术适应症和治疗策略。
仅一小部分脊柱椎间盘炎患者需要手术干预。在比较保守治疗和手术治疗的研究中，大多数患者从手术中获益，无论选择何种手术技术。目前，标准手术是联合前后路手术，其中应始终尝试单侧手术。腹侧支撑材料（聚醚醚酮、钛）的选择不影响临床结果。
