TOTBİD Dergisi

TOTBİD Dergisi

2011, Cilt 10, Sayı, 4     (Sayfalar: 289-295)

Spinal infections

Alpaslan Şenköylü 1, Necdet S. Altun 1

1 Gazi Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı, Ankara

Görüntüleme: 615
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İndirme : 891

Spinal infections represent an age-old disease with a recorded history which probably dates back before the time of Hippocrates. The vertebrae are infected haematogenously as a result of bacteremia originating from another focus. Back pain at the rest is generally the primary complaint of the patients. Major neurologic problems are not common. Gibbus is a kind of sharp kyphosis, which is a pathognomonic sign of the spinal tuberculosis. Isolation of the causitive microorganism is very important for the treatment. The diagnosis is delayed for more than one month in two-thirds of the patients. Magnetic resonance imaging is the most specific, sensitive and reliable imaging study for the spinal infections. Most patients may respond to medical management with culture-specific antibiotics and external corset immobilization. Indications for surgery include failure to respond to medical management, failure to isolate the causative microorganism, progressive neurological deficit, spinal instability, kyphotic deformity, persistent pain, and abscess formation. Radical debridement is the key for the surgical treatment. Recently, it was shown that titanium implants can be used safely for reconstruction.

Anahtar Kelimeler : Diagnosis; spinal infections; spondylodiscitis; treatment