Spondylodiscitis Diagnosis And Treatment

Background and purpose:Spondylodiscitis mean vertebral discitis and vertebral end-plate gap of infectious diseases.it is divided into primary and secondary discitis.Primary discitis is rare,it can occur at any age, but was particularly prevalent in the elderly[1,2];Secondary spondylodiscitis is often referred to as post-operative discitis,spinal surgery is a serious complication.The disease may appear in the cervical,thoracic,lumbar spine,lumbar spine is the most common, Jonathan[19] and other reports,the incidence of cervical is 10%,thoracic 34%,lumbar 59%,the incidence of multi-segment is 28%.For the cause of discitis are not present the views of the same,the incidence of risk factors,common pathogens,clinical manifest- ations,and imaging features,treatment,lack of a systematic understanding of the principles,clinical work is easily missed diagnosis or misdiagnosis.This report explore the clinical characteristics and surgical treatment.of the primary and secondary lumbar discitis.Methods:Analysis of 10 cases of discitis(primary spondylodiscitis four cases,six cases of secondary spondylodiscitis) that the etiology,clinical manifestations,including ESR,CRP,imaging characteristics and the results of bacteriological culture(5 cases operative treatment,5 cases of non- operative treatment),efficiency of treatment is determined by low back pain disappear,ESR,CRP,the time of leaving bed and the rate of interbody fusion.Results:Discitis usually persistent severe low back pain,leukocytes can be increased,ESR,CRP increased.Course of 4 weeks or more x-ray films showed narrow intervertebral space,destruction of adjacent vertebral body and the edge of ambiguity;CT showed bone destruction of vertebral body, hyperplasia of vertebral body the edge;MRI is important diagnostic value,MRI showed that the adjacent vertebral body and intervertebral disc lesions after discitis is taken in 1-2weeks,T1-weighted image showed low signal intensity,T2-weighted images showed high signal.Comparison of operative treatment group and non-operative treatment group,the relieve of the spastic pain of the operation group was significantly shartor than non-operation group,patients of post-operation are able to walk after 4-7days.Others symptoms and laboratory results are greatly improved.Conclusion:The diagnosis of primary spondylodiscitis can be built by the acute low back pain and muscle spasm,localized deep tenderness and the increase of WBC,CRP and ESR.Once the severe postoperative back pain and with ESR and CRP increase,secondary spondylodiscitis should be suspected.MRI can provide early diagnosis for spondylodiscitis operation can effectively relieve symptoms and achieve clinical treatment.Surgical treatment can be:â‘ the complete removal of lesions and decrease the course of disease.â‘¡the restoration of intervertebral height and curvature.â‘¢promote the fusion of the vertebral section.â‘£patients can leaving bed early and avoided the toxicity of application of antibiotics.