腰椎髓核摘除术后椎间隙感染的诊断治疗

Diagnosis and treatment of the postoperative intervertebral space infection of lumbar discectomy

目的探讨腰椎髓核摘除术后椎间隙感染的诊断及治疗方法。方法对本院10年来7例腰椎髓核摘除术后椎间隙感染的病例进行回顾性分析。对于早期有迹象表明术后椎间隙感染的患者,治疗要求上绝对卧床,早期静脉联合应用大剂量抗生素,并适当给予激素;2周后没有明显疗效的患者,且腰部症状进行性加重,伴有抽搐及高热等症状或者高热消退后再次出现高热的患者,应尽早行病灶清除及灌洗引流术。结果 7例椎间隙感染患者,非手术治疗4例,手术治疗3例。7例患者均治愈,术后6～12周在腰椎保护下行走。随访6个月～1年,效果优良。结论发现椎间隙有感染的迹象,应尽早治疗,一旦保守治疗效果较差,应立即行病灶清除及灌洗引流术。

Objective To explore the diagnosis and treatment of lumbar intervertebral space infection after removal of lumbar intervertebral disc. Methods From September 2001 to December 2011, 7 cases with lumbar interspace infection after removal of lumbar intervertebral disc were analyzed retrospectively.Early immobilization and the use of anti biotics in combination and adequate corticosteroid is recommended. Patients with severe symptoms were managed by percutaneous puncture and washing discectomy such as rising temperature and perivertebral muscle spasm, and early debridement of all necrotic tissue was done. Results 4 were healed by non-operation and operation in the other 3.All had gotten locomotion with corset after the operation for 6-12 weeks and were followed-up from 6 months to 1 years.They have achieved excellent outcomes. Conclusion When a postoperative disc space infection occurs, early diagnosis and treatment should be undertaken to achieve excellent outcomes.