经皮椎体成形术后表皮葡萄球菌性化脓脊柱炎:1例报道与综述

Pyogenic spondylitis of Staphylococcus epidermidis secondary to percutaneous vertebroplasty:a case report and literature review

本文报道1例72岁男性患者因为椎体骨折接受经皮椎体成形术(percutaneous vertebroplasty,PVP)出现表皮葡萄球菌感染,经清创及内固定手术治疗后痊愈。PVP后感染的概率很低,文献中报道其发生率为0.04%~1.02%,椎体感染的细菌主要来源于血液播散。肺部、胆道、肠道,甚至皮肤痤疮的细菌均有可能通过血液迁移至椎体导致椎体炎症发生。接受PVP多为老年患者,免疫力较青壮年低,无疑增加了椎体感染的风险,虽然PVP为微创手术,仍应严格执行无菌操作规范,认真并彻底消毒手术野,方能减少术后感染的风险。

This article reports a 72-year-old male who underwent percutaneous vertebroplasty(PVP)due to vertebral fracture,and developed Staphylococcus epidermidis spondylitis,was cured after debridement and internal fixation surgery.The probability of infection after PVP is very low,with incidence of 0.04%~1.02%reported in the literature.The bacteria of vertebral body infection mainly come from blood spread,which might be from the lungs,bile ducts,intestines,and even skin acne,and migrate to the vertebral body through the blood and cause infectious lesions on the vertebral body.Most patients receiving PVP are elderly patients,and their immunity is lower than that of young adults,which undoubtedly increases the risk of vertebral infection.Although PVP is a minimally invasive surgery,strict aseptic operation specifications should be implemented,and the surgical field should be carefully and thoroughly disinfected to reduce the risk of spinal infection after surgery.