术后腰椎间盘炎的治疗体会  

The experiences in treating postoperative lumbar discitis

作　　者：李晓华[1] 程维[1] 郑昊[1] 张俊峰[1] 

机构地区：[1]吉化集团公司总医院骨科,吉林吉林132000

出　　处：《吉林医学》2004年第8期27-28,共2页Jilin Medical Journal

摘　　要：目的:探讨术后腰间盘炎的病因,诊断方法及治疗。方法:根据6例腰椎间盘炎的临床表现、化验检查及治疗、预后,分析其病因及治疗体会。结果:本组术后腰间盘炎的发生率为1.3%,2例有腰部剧痛、痉挛伴下肢抽搐,余4例呈腰部剧痛伴发热,患者血沉及C反应蛋白均升高,4例行手术治疗,术中取材细菌培养均阴性。2例行保守治疗,6例病人均在术后2个月内症状明显减轻,,3～6个月随腰椎间隙融合而症状缓解。结论:术后腰椎间盘炎分三类,以自身免疫反应及无菌性炎症为主;腰部剧痛与痉挛、血沉及C反应蛋白增高、腰椎MRI检查是术后腰间盘炎的诊断要点,患者可随腰椎间隙完全融合而症状缓解。Objective To discuss the causes,diagnostic methods and treatment of postoperative lumbar discitis. Methods To analyse the causes,experiences in treating lumbar discitis according to its clinical symptoms,tests,treatment and recovering results. Results The rate of postoperative lumbar discitis is 1.3% in this group,2 cases suffered from serious back pain, spasm and legs spasm, other 4 cases suffered from serious back pain and fever, all the patients whose ESR,C-RP were high, 4 cases were operated ,the specimens in the operations were kept bacterial cultivation and the results were negative. 2 cases were treated by conservative methods. All the patients whose symptoms were obviously relieved in 2 months and completely disappeared in 3 to 6 months as the lumbar vertebral clefts fusion. Conclusion The postoperative lumbar discitis is classified to three categorys and majority of them are autoimmune and inflammition no bacteria, serious back pain, spasm, ESR,C-RP arised and MRI are the key to diagnose postoperative lumbar discitis. The patients will recover completely as their lumbar vertebral clefts fusion.

关 键 词：腰椎间盘炎 并发症 髓核 糖皮质激素 

分 类 号：R687.3[医药卫生—骨科学]