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脊柱内镜术后腰椎间隙感染的临床特征及处理:一项回顾性分析

Clinical features and management of postoperative lumbar intervertebral space infections following spinal endoscopy: a retrospective analysis.

作者信息

Su Kunpeng, Liu Mingzhi, Wang Mengxuan, Yao Qingyu, Wang Zirui, Lian Zheng, Zhou Chuanli

机构信息

Department of Spinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.

Department of Medicine, Qingdao University, Qingdao, Shandong, China.

出版信息

Front Cell Infect Microbiol. 2025 May 19;15:1538779. doi: 10.3389/fcimb.2025.1538779. eCollection 2025.

Abstract

BACKGROUND

Postoperative lumbar intervertebral space infections following spinal endoscopy are infrequent but severe complications that can markedly affect patient recovery and treatment outcomes. Early diagnosis remains challenging due to the nonspecific nature of clinical symptoms. This study aims to identify the clinical characteristics, risk factors, and effective diagnostic and treatment strategies for postoperative intervertebral space infections.

METHODS

A retrospective analysis was conducted on 14 cases of postoperative intervertebral space infections following spinal endoscopy. The data set included patient demographics, clinical symptoms, imaging findings, blood culture results, and treatment approaches. The analysis assessed early diagnosis and treatment outcomes concerning the infection's progression and the use of MRI, inflammatory markers, and empirical antibiotics.

RESULTS

The most common clinical symptoms included localized back pain, neurological deficits, and fever, though these lacked specificity. MRI proved valuable in diagnosing early infections. The majority of cases exhibited elevated levels of inflammatory markers, such as CRP and ESR. The treatment plan included early surgical intervention with debridement and internal fixation, along with extended antibiotic therapy.

CONCLUSION

The early identification and intervention of postoperative intervertebral space infections following spinal endoscopy are of critical importance. The implementation of a strict aseptic technique, the execution of careful preoperative planning, and the timely use of MRI for diagnosis are essential to the prevention and effective treatment of these infections. This study underscores the necessity of a comprehensive approach to minimize the risk of postoperative intervertebral space infections and to enhance patient outcomes.

摘要

背景

脊柱内镜术后腰椎间隙感染虽不常见,但却是严重并发症,可显著影响患者康复及治疗效果。由于临床症状缺乏特异性,早期诊断仍具有挑战性。本研究旨在确定术后椎间间隙感染的临床特征、危险因素以及有效的诊断和治疗策略。

方法

对14例脊柱内镜术后椎间间隙感染病例进行回顾性分析。数据集包括患者人口统计学资料、临床症状、影像学检查结果、血培养结果及治疗方法。该分析评估了关于感染进展以及MRI、炎症标志物和经验性抗生素使用情况的早期诊断和治疗效果。

结果

最常见的临床症状包括局部背痛、神经功能缺损和发热,不过这些症状缺乏特异性。MRI被证明在早期感染诊断中具有重要价值。大多数病例炎症标志物水平升高,如CRP和ESR。治疗方案包括早期手术清创及内固定干预,以及延长抗生素治疗。

结论

脊柱内镜术后椎间间隙感染的早期识别和干预至关重要。实施严格的无菌技术、进行仔细的术前规划以及及时使用MRI进行诊断对于预防和有效治疗这些感染至关重要。本研究强调了采取综合方法以降低术后椎间间隙感染风险并改善患者治疗效果的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3682/12127424/00ddb062d443/fcimb-15-1538779-g001.jpg

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