| A Clinical Analysis of Postoperative Lumbar Spondylodiscitis |
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Sung-Wun Jung, M.D, Kwan-Ho Park, M.D., Tae-Wan Kim, M.D., Jae-O Kim, M.D., Jung-Chul Kim, M.D. |
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Deparment of Neurosurgery, Seoul Veterans Hospital, Seoul, Korea |
| 요추 수술 후에 발생한 척추디스크염 환자에 대한 임상적 고찰 |
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정성운,박관호,김태완,김재오,김정철 |
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서울보훈병원 신경외과학교실 |
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| Abstract |
Objective
We report a retrospective analysis of the clinical manifestation and treatment of spondylodiscitis after lumbar spine operation in our department.
Methods
From January 2000 to June 2004, we treated 23 patients with postoperative lumbar spondylodiscitis with conser- vative and surgical methods. We analyzed the clinical and laboratory results, radiological changes, and the treatments adopted.
Results
Twenty three cases(17 men and 6 women, of average age 64.1 years(range, 36節79) were enrolled. All patients com- plained of severe back pain. Risk factors predisposing to the risk of infection included advanced age in fourteen cases and diabetes mellitus in seven. In twenty three cases, serum erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) levels remained elevated until 2 weeks after surgery. MR(magnetic resonance) images demonstrated that the involved disc and adjacent vertebral bodies showed low signal intensity on T1-weighted images(T1WI). Staphylococcus sp. was the most common organism found by bacteriologic culture of tissue specimens. Sixteen cases were treated conservatively and seven surgically.
Conclusion
Monitoring of patient response to treatment, repeated laboratory studies, an MRI examination, and bacteriologic culture of tissue specimens are required for the early detection of postoperative spondylodiscitis Proper antibiotics and/or the surgical removal of infective tissues are necessary to reduce the complications associated with spondylodiscitis. Periodic exa- mination and normalization of ESR and CRP are essential in the evaluation of the treatment and termination of antibiotics treatment. |
| Keywords:
Spondylodiscitis.Spine operation.Erythrocyte sedimentaion rate.C-reactive protein.Magnetic resonance images |
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