Ring D, Wenger D R
Department of Orthopedics, Children's Hospital-San Diego, California, USA.
Am J Orthop (Belle Mead NJ). 1996 May;25(5):342-8.
The historic evolution of pyogenic infectious spondylitis from its initial descriptions to its current characterization illustrates the degree to which our means of perception and evaluation influence our understanding of an illness. As new concepts resulting from medical innovations challenge traditional beliefs regarding the etiology and optimum treatment of pyogenic infectious spondylitis in children (commonly termed discitis), controversies have arisen. This review attempts to clarify these issues by reconstructing their historic basis and delineating the limitations of our current knowledge. In our opinion, this exercise demonstrates the similarities between pyogenic infectious spondylitis in children and adults and provides support for the management of this illness at all ages with parenteral antibiotics, cast or brace immobilization when needed for symptomatic relief, and, rarely, operative débridement.
化脓性感染性脊柱炎从最初被描述到当前特征的历史演变，说明了我们的认知和评估方式在多大程度上影响我们对一种疾病的理解。随着医学创新产生的新概念挑战了关于儿童化脓性感染性脊柱炎（通常称为椎间盘炎）的病因和最佳治疗的传统观念，争议随之出现。本综述试图通过重构其历史基础并阐明我们现有知识的局限性来澄清这些问题。我们认为，这项研究展示了儿童和成人化脓性感染性脊柱炎之间的相似之处，并为各年龄段该疾病的治疗提供了支持，即采用胃肠外抗生素治疗，必要时使用石膏或支具固定以缓解症状，以及极少情况下进行手术清创。
