Grane P, Josephsson A, Seferlis A, Tullberg T
Department of Neuroradiology, Karolinska Hospital, Stockholm, Sweden.
Acta Radiol. 1998 Mar;39(2):108-15. doi: 10.1080/02841859809172162.
The aim of this study was to determine whether it was possible to differentiate septic from aseptic post-operative discitis in the lumbar spine by means of MR imaging.
The study was a retrospective evaluation of 12 patients with prior lumbar discectomy and suspected post-operative discitis displaying low-back pain and typical MR findings. Six patients had elevated serum C-reactive protein (CRP) (septic) and 6 had normal CRP (aseptic). We used MR imaging to assess the distribution and degree of changes in the disc, in adjacent bone marrow, and in surrounding soft tissue.
Of the 6 patients with increased CRP levels, 3 had extensive MR changes typical of septic post-operative discitis: 1 found soon after surgery; 2 found later. The other 3 patients with septic discitis, who were examined in the early post-operative period, showed MR changes similar to those in the 6 patients with aseptic discitis.
Suspicion of septic post-operative discitis should be confirmed by MR imaging, serum CRP, and disc puncture. MR imaging is not reliable as the sole method for distinguishing septic from aseptic discitis in the early post-operative stage.
本研究的目的是确定是否可以通过磁共振成像（MR成像）来区分腰椎术后感染性椎间盘炎和无菌性椎间盘炎。
本研究是对12例既往有腰椎间盘切除术且疑似术后椎间盘炎的患者进行回顾性评估，这些患者均表现出腰痛和典型的MR表现。6例患者血清C反应蛋白（CRP）升高（感染性），6例患者CRP正常（无菌性）。我们使用MR成像来评估椎间盘、相邻骨髓和周围软组织的变化分布及程度。
在6例CRP水平升高的患者中，3例有广泛的MR改变，典型的术后感染性椎间盘炎表现：1例在术后不久发现；2例在后期发现。另外3例感染性椎间盘炎患者在术后早期接受检查，其MR改变与6例无菌性椎间盘炎患者相似。
术后感染性椎间盘炎的诊断应通过MR成像、血清CRP和椎间盘穿刺来确诊。在术后早期，MR成像作为区分感染性和无菌性椎间盘炎的唯一方法并不可靠。
