Peterson H A
Instr Course Lect. 1983;32:50-60.
Disk-space infection and vertebral osteomyelitis are two separate entities. Disk-space infection is an isolated soft tissue infection usually caused by coagulase-positive S. aureus. There is reactive osteolytic and osteoblastic activity in the two adjacent vertebral end-plates. Treatment by immobilization alone usually produces a satisfactory outcome. A satisfactory outcome can be accomplished by bed rest or use of a corset or cast. Infrequently, needle biopsy or open biopsy may be necessary for the diagnosis and treatment of resistant disease; this usually is needed in an older child. Surgery and antibiotics are indicated in patients with persistent symptoms, persistent elevation of the sedimentation rate, and failure of the radiologic changes to improve. The findings and recommendations concerning children should not be applied to adults.
椎间盘间隙感染和椎体骨髓炎是两种不同的病症。椎间盘间隙感染是一种孤立的软组织感染，通常由凝固酶阳性的金黄色葡萄球菌引起。相邻的两个椎体终板会出现反应性骨质溶解和成骨活动。仅通过固定治疗通常能取得满意的效果。卧床休息、使用紧身胸衣或石膏固定均可达到满意的治疗效果。少数情况下，对于耐药性疾病的诊断和治疗可能需要进行针吸活检或开放活检；这在大龄儿童中通常是必要的。对于有持续症状、血沉持续升高且影像学改变无改善的患者，需进行手术并使用抗生素治疗。关于儿童的这些发现和建议不适用于成人。
