Glazer P A, Hu S S
Department of Orthopaedic Surgery, University of California, San Francisco, USA.
Orthop Clin North Am. 1996 Jan;27(1):111-23.
A high index of suspicion for spinal infection and an appropriate and prompt diagnosis are essential for the treatment of pediatric spinal infections. A 3-week course of antibiotics and supportive therapy is effective in the majority of cases of discitis, the most common pediatric spinal infection. Patients who are not toxic may be treated with bracing, or with casting alone in many cases. Neurologic deficit or a failure to respond to early treatment requires more aggressive measures, including biopsy or surgical debridement. It is essential to diagnose rare but serious conditions such as epidural abscess, tuberculosis, or opportunistic infections in patients at risk. The authors stress that clinical evaluation and appropriate diagnosis are critical for prevention of permanent neurologic damage or late bony deformity.
对小儿脊柱感染保持高度怀疑指数以及进行恰当且及时的诊断对于小儿脊柱感染的治疗至关重要。在大多数椎间盘炎（最常见的小儿脊柱感染）病例中，为期3周的抗生素治疗和支持性治疗是有效的。无毒血症的患者可采用支具治疗，在许多情况下单独使用石膏固定即可。神经功能缺损或对早期治疗无反应则需要采取更积极的措施，包括活检或手术清创。对于有风险的患者，诊断罕见但严重的疾病如硬膜外脓肿、结核病或机会性感染至关重要。作者强调，临床评估和恰当诊断对于预防永久性神经损伤或晚期骨骼畸形至关重要。
