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原发性椎间盘炎的临床特点及前路手术探讨 被引量:4

The clinical characteristics and anterior route surgical treatment of spontaneous infectious discitis
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摘要 目的 探讨原发性椎间盘炎的临床特点及外科手术治疗方法。方法 分析 5例经外科手术确诊的原发性椎间盘炎患者的临床表现、影像学特点、细菌学培养结果及在大剂量抗生素治疗的同时前路手术的临床疗效。结果 剧烈痉挛性腰痛、腰部活动严重受限、持续性低热、血沉增快是本病的主要临床表现 ,MRI检查对诊断有重要价值 ,可作早期诊断 ,2例细菌学培养阳性 ,3例为阴性 ,本组病例均行前路病灶清除 ,植骨融合并内固定 ,剧烈腰痛明显缓解 ,不再需用止痛剂 ,5例均治愈。结论 如诊断明确 ,短期保守治疗无效者 ,宜早期手术 ,前路病灶清除植骨内固定能迅速缓解症状 ,缩短病程 ,是治疗本病最为有效的手段之一。 Objective To study the clinical characteristics and surgical treatment of spontaneous infectious discitis of the lumbar spine.Methods 5 cases of spontaneous infectious discitis were analysed retrospectively.Their clinical courses,the imaging examination and the bacterial cuture were studied.All patients were treated with anterior route operation combined with antibiotics.Rseults The severe spasmodic back pain,the limitation of back motion and the lasting low fever were main clinical courses of the spontaneous discitis.ESR was very useful in the diagnosis.MRI played important roles in the early diagnosis and in the differential diagnosis with tumor,tuberculosis and degenerative changosis of the lumbar intervertebral space.2 cases were positive in the bacterial cuture and 3 cases were negative.After the surgery of anterior route disc debridement and iliac autograft with internal fixation,the symptoms were relieved in a short time.The roentgenographic follow-up showed the intervertebral fusion 2.5~3.5 months after surgery.Conclusion The surgery of the anterior route debridement has more advantages over thr conservative treatment.It is one of the most effective methods of treatment of the spontaneous infectious discitis.
出处 《颈腰痛杂志》 2004年第2期105-107,共3页 The Journal of Cervicodynia and Lumbodynia
关键词 原发性椎间盘炎 临床特点 前路手术 外科手术 治疗 discitis disc space infection lumbar internal fixation
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