同轴双管持续性冲洗引流治疗腰椎间盘术后椎间隙感染

Treatment of postoperative intervertebral discitis of the lumbar spine by continued washing and draining with double-tube

目的 报告 9例腰椎间盘摘除术后椎间隙感染 ,用同轴双管持续性冲洗引流方法治疗的效果。方法 运用经皮穿刺腰椎间盘切吸技术和相应设备 ,在C臂X线机下穿刺进入感染椎间隙 ,抗生素液进行持续性冲洗引流。L4～5椎间隙 8例 ,L5～S1 椎间隙 1例。全身正确制动和支持治疗相配合。冲洗时间 :2～7d,平均 4 2d。绝对卧床时间 32～ 71d ,平均 58d。结果 症状缓解最早在术后 3h ,最晚 1 2h。 9例全部得到随访 ,随访时间 6～ 66个月 ,平均 2 5个月。疗效评定 :根据改良的Macnad评分标准[1 ] ,优良率超过 89 9%。结论 同轴双管持续性冲洗引流治疗腰椎间盘术后椎间隙感染 ,抗生素液直接到达感染间隙 ,有效控制感染 。

Objective To study 9 cases of postoperative intervertebral discitis of lumbar spine treated by continued washing and draining with double tube.Methods Under X ray,washing and draining with double tube and antibiotics was continued by percutaneous lumbar centesis through L 4～5 in 8 cases and through L 5 ～S 1 in 1 case.The time of washing ranged from 2 to 7days with an average of 4.2 days.Results The time of symptom alleviating ranged from 3 hours to 12 hours.9 cases were followed up for 6 months to 66 months with an average of 25 months.The results were excellet in eight cases(89.9%)and fairly good in 1 cases(11%)by Macnad standard.Conclusion It is effective to treat postoperative intervertebral discitis of the lumbar spine by continued washing and draining with double tube,because it can control infection and alleviate symptoms.