术后腰椎关节盘炎13例分析

Analysis of postoperative lumbar discitis in 13 patients after surgery of lumbar vertebrae

目的探讨腰椎手术后腰椎关节盘炎(LD)的诊断与治疗方法。方法回顾性分析13例腰椎手术后LD资料。结果术后严重的腰痛、血沉、C-反应蛋白持续增高是LD的主要临床特点,MRI具有早期诊断作用。9例保守治疗,4例手术治疗,所有患者获得治愈;但2例遗留有腰痛和腰椎活动受限。结论腰椎手术症状缓解后再次出现剧烈腰痛,血沉、C-反应蛋白显著持续升高应当考虑术后LD可能,MRI检查能够提供早期诊断证据。多数患者经保守治疗可以治愈,炎症进展时,应行病灶清除术。

Objective To summarize the diagnosis and treatment of the postoperative lumbar discitis.Methods Data of 13 caeas with postoperative lumbar discitis after surgery of the lumbar vertebrae were retrospectively analyzed.Results Severe lumbar back pain with an increase of erythrocyte sedimentation rate and C reactive protein were the major clinical characteristics of discitis.MRI played important role in the early diagnosis.Nine patients were treated by conservative methods and four cases were treated by surgery.All patients were cured except that 2 cases had lumbar back pain and limited lumbar movement.Conclusion Postoperative discitis should be considered in case of recurrence of severe pain of lumbar back,sustained increases of C reactive protein and erythrocyte sedimentation rate.MRI immaging is the most imporrant evidence for the early diagnosis of discitis.Most of the patients can be cured with conservative treatment.Surgery is indicated when the infection is progreesing after conservative treatment.