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[感染性脊椎椎间盘炎——背痛的重要鉴别诊断]

[Infectious spondylodiscitis--an important differential diagnosis in backache].

作者信息

Klöti M, Ludwig C

机构信息

Internmedizinische Abteilung, St. Claraspital Basel.

出版信息

Praxis (Bern 1994). 1998 May 27;87(22):753-8.

PMID:9654989
Abstract

All cases of spondylodiscitis diagnosed in our hospital between January 93 and April 96 have been analysed retrospectively. With regard to potentially severe complications, spondylodiscitis is an important differential diagnosis of back pain. In our results 50% of the patients had a positive bacterial culture either from blood or tissue. No complication has been observed. The most relevant diagnostic procedures are: determination of CRP, magnetic resonance imaging and eventually computed tomography in combination with biopsy and blood cultures. Magnetic resonance imaging is a very sensitive method for early stage osteomyelitis. Antimicrobial therapy should be based on the result of culture and sensitivity tests. An antibiotic with good penetration into bone is preferred.

摘要

我们对1993年1月至1996年4月间在我院诊断的所有脊椎椎间盘炎病例进行了回顾性分析。就潜在的严重并发症而言,脊椎椎间盘炎是背痛的重要鉴别诊断。在我们的研究结果中,50%的患者血液或组织细菌培养呈阳性。未观察到并发症。最相关的诊断程序是:测定CRP、磁共振成像,最终结合活检和血培养进行计算机断层扫描。磁共振成像是早期骨髓炎非常敏感的方法。抗菌治疗应基于培养和药敏试验结果。首选对骨有良好渗透性的抗生素。

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