Stabile Guglielmo, Romano Federico, Topouzova Ghergana A, Mangino Francesco Paolo, Di Lorenzo Giovanni, Laganà Antonio Simone, De Manzini Nicolò, Ricci Giuseppe
Department of Gynecology and Obstetrics, Institute for Maternal and Child Health Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) "Burlo Garofolo", Trieste, Italy.
University Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
Front Surg. 2021 Oct 29;8:741311. doi: 10.3389/fsurg.2021.741311. eCollection 2021.
Spondylodiscitis can be a rare complication of gynecological surgery, typically of procedures involving the sacrum and the sacrospinous ligament. This report presents a case of spondylodiscitis arising after a laparoscopic sacrocolpopexy with a mesh. We also review the literature finding 52 cases of spondylodiscitis following sacrocolpopexy and (or) rectopexy with or without a mesh. We performed a comprehensive search from the electronic databases MEDLINE (Pubmed), Scopus, Web of Science, Embase, CINAHL, and Google Scholar from 1990 to February 2021 in order to identify case reports or case series reporting on spondylodiscitis after rectopexy or sacrocolpopexy. We identified 52 total postoperative spondylodiscitis. We examined the mean age of patients, the surgical history, the time from initial surgery to spondylodiscitis, the presenting symptoms, the diagnostic tools, the medical and surgical treatment, the type of mesh used, the surgical access, and the possible causes of spondylodiscitis. Diagnosis of spondylodiscitis may be challenging. From our review emerges that recurrent pelvic pain and lumbosciatalgia may be signals of lumbar spondylodiscitis. Magnetic resonance is the gold standard examination for spondylodiscitis. Surgical practice needs to be improved further in order to establish the best procedure to minimize the incidence of this complication. Awareness of symptoms, timely diagnosis, and treatment are fundamental to prevent irreversible complications.
脊椎椎间盘炎可能是妇科手术的一种罕见并发症，通常发生在涉及骶骨和骶棘韧带的手术中。本报告介绍了一例腹腔镜骶骨阴道固定术加用补片后发生脊椎椎间盘炎的病例。我们还回顾了文献，发现52例骶骨阴道固定术和（或）直肠固定术（无论有无补片）后发生脊椎椎间盘炎的病例。为了确定关于直肠固定术或骶骨阴道固定术后脊椎椎间盘炎的病例报告或病例系列，我们对1990年至2021年2月期间的电子数据库MEDLINE（PubMed）、Scopus、科学网、Embase、护理学与健康领域数据库（CINAHL）和谷歌学术进行了全面检索。我们共确定了52例术后脊椎椎间盘炎病例。我们研究了患者的平均年龄、手术史、初次手术至发生脊椎椎间盘炎的时间、出现的症状、诊断工具、内科和外科治疗、所用补片的类型、手术入路以及脊椎椎间盘炎的可能原因。脊椎椎间盘炎的诊断可能具有挑战性。从我们的综述中可以看出，复发性盆腔疼痛和腰腿痛可能是腰椎脊椎椎间盘炎的信号。磁共振成像（MRI）是脊椎椎间盘炎的金标准检查。为了确定最佳手术方法以尽量减少这种并发症的发生率，手术操作需要进一步改进。对症状的认识、及时诊断和治疗对于预防不可逆并发症至关重要。
