Mattie Ryan, Schneider Byron J, Miller David C, Popescu Adrian, Smith Clark C, McCormick Zachary L
Total Spine Institute, Los Angeles, CA, USA.
Vanderbilt University Medical Center, Dept of Physical Medicine & Rehabilitation, Nashville, TN, USA.
Interv Pain Med. 2022 Nov 25;1(4):100150. doi: 10.1016/j.inpm.2022.100150. eCollection 2022 Dec.
This series of FactFinders presents a brief summary of the evidence and outlines recommendations regarding the use of antibiotics for disc access and spinal cord stimulation trials. The evidence in support of the following facts is presented: (1) There is a low but nonzero risk of discitis due to percutaneous intervertebral disc access. Strategies to mitigate this risk include use of strict aseptic technique, use of a needle stylet, and prophylactic intravenous or intra-discal antibiotics. (2) In low-risk patients, it may not be necessary to continue antibiotics throughout the percutaneous or staged trial period; however, in high-risk patients, or in trials lasting more than five days, antibiotics should be considered on a case-by-case basis.
本系列《事实发现者》简要总结了相关证据，并概述了关于椎间盘穿刺和脊髓刺激试验中使用抗生素的建议。以下是支持这些事实的证据：（1）经皮椎间盘穿刺存在椎间盘炎风险，虽风险较低但不为零。降低此风险的策略包括采用严格的无菌技术、使用针芯以及预防性静脉或椎间盘内使用抗生素。（2）在低风险患者中，在整个经皮或分期试验期间可能无需持续使用抗生素；然而，对于高风险患者或试验持续超过五天的情况，应根据具体情况考虑使用抗生素。
