腰椎间盘突出症术后椎间隙感染的诊断和治疗  

Diagnosis and Treatment of Disc Space Infection after Lumbar Discetomy

作　　者：茹选良[1] 赵大正[1] 

机构地区：[1]浙江医院,杭州310013

出　　处：《中国骨伤》1997年第5期15-17,共3页China Journal of Orthopaedics and Traumatology

摘　　要：本文报道了14例腰突症术后椎间隙感染的诊断治疗。本病的临床特征为术后腰腿痛消失4～27天，又突然出现剧烈腰痛，伴有腹痛，下肢放射痛，不规则低热。白细胞计数可轻度升高或正常，但血沉升高。早期X线平片和CT检查无多大价值。MRI可以清晰显示炎症的部位，范围和程度。对早期诊断具有非常重要的意义。组织活检有助于确诊，但阳性率低。本病一旦被诊断，应严格卧床制动，用大剂量广谱抗菌素治疗。保守治疗有效。14 patients with disc space infecion after lumbar discetomy had been diagnosed and treated from September 1989 to July 1995. The clinical features of this disease were acute serious lumbago 4 to 27 days (9 days in average ) after operation, accompanied with abdominal pain, leg pain with radiation, and irregular low fever. The leukocyte count was mildly increased or normal, and the erythrocyte sedimentation rate was obviously elevated. The CT scan and roentgenograms were not helpful in early stage. The MRI could clearly demonstrate the place, range and extent of diskitis and achieved an important value for early diagnosis of diskitis. The needle biopsy culture was helpful to diagnosis, but only with low positive rate. After a definitive diagnosis had been made, the conservative treatment was immediately taken with large doses of broad -spectrum antibiotics and strict bed rest. The therapeutic effect was good after following - up for 22 months.

关 键 词：椎间盘炎 腰椎间盘突出 诊断 治疗 外科手术 

分 类 号：R681.53[医药卫生—骨科学]