University of Health Sciences, Gazi Yasargil Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Diyarbakir, Turkey.
University of Health Sciences, Van Training and Research Hospital, Department of Orthopedy, Van, Turkey.
J Int Med Res. 2021 Nov;49(11):3000605211060197. doi: 10.1177/03000605211060197.
Spondylodiscitis is an important clinical a problem requiring serious approaches. In this study, we sought to raise awareness by examining the epidemiology and laboratory, clinical, and radiological findings of spondylodiscitis, which sometimes has a delayed diagnosis and which can be difficult to treat.
In total, 343 patients with spondylodiscitis were included in the study.
The patients were classified as having as pyogenic (n = 153, 44.6%), brucellar (n = 138, 40.2%), or tuberculous (n = 52, 15.2%) spondylodiscitis. Meanwhile, 281 patients underwent magnetic resonance imaging, 71 underwent computed tomography, and 17 underwent scintigraphy for diagnosis. The rates of involvement at more than two segments and paraspinal abscess were significantly higher in tuberculous spondylodiscitis. However, disc involvement was significantly more common in brucellar and pyogenic spondylodiscitis.
The incidence of spondylodiscitis has increased substantially, especially in the young population. The invasive procedures and high rate of culture negativity make the diagnosis difficult. Therefore, clinical and radiological findings are useful in the diagnosis of spondylodiscitis. Despite the high rate of culture negativity, every effort should be made to identify the causative organism using invasive methods.
椎间盘炎是一个需要认真对待的重要临床问题。本研究通过分析椎间盘炎的流行病学以及实验室、临床和影像学表现,旨在提高对此病的认识,因为该病有时诊断较迟,且治疗较为困难。
共纳入 343 例椎间盘炎患者。
患者分为化脓性(n=153,44.6%)、布氏杆菌(n=138,40.2%)或结核性(n=52,15.2%)椎间盘炎。281 例行磁共振成像,71 例行计算机断层扫描,17 例行闪烁扫描进行诊断。与结核性椎间盘炎相比,多个节段受累和椎旁脓肿的发生率明显更高。然而,布氏杆菌和化脓性椎间盘炎中椎间盘受累明显更常见。
椎间盘炎的发病率显著增加,尤其是在年轻人群中。侵袭性操作和高比例的培养阴性使诊断变得困难。因此,临床和影像学表现有助于椎间盘炎的诊断。尽管培养的阳性率较高,但仍应通过侵袭性方法尽力识别病原体。