TOTBİD Dergisi

TOTBİD Dergisi

2015, Cilt 14, Sayı, 4     (Sayfalar: 319-322)

Lowback pain and fever: spine infections

Akif Albayrak 1, Mehmet Bülent Balioğlu 1

1 M. S. Baltalimanı Kemik Hastanesi, İstanbul

DOI: 10.14292/totbid.dergisi.2015.50
Görüntüleme: 2448
İndirme : 674

Spine infections, according to the etiologic agent, is divided as pyogenic or granulomatous. Pyogenic spine infections are also known as spondylodiscitis. In granulomatous infections, tuberculosis bacillus emerges as the most common cause of the infection. Tuberculosis most commonly settles in the metaphyseal part of the spine. Paravertebral abscess formation to the cranial and caudal lying beneath the anterior longitudinal ligament is called Pott abscess. In case of subacute and chronic infections caused by low virulence microorganisms, patients may consult a doctor with a persistent and insidious low back pain. In the laboratory analysis; increased white blood cells in 42% and erythrocyte sedimentation increase in 92% of the patients are seen and the C-reactive protein is an acute phase reactant which increases within 4-6 hours and folding every eight hours if an infection or inflammation occurs. For Pott probability, Chest X-Ray of the patient must be obtained. Gallium and technetium scintigraphy is positive earlier than plain X-rays findings. Magnetic resonance imaging is as sensitive as radionuclide imaging alone (%96), and it is also possible to distinguish infection and malignancy from each other at a very high rate (%93). Recommended medical treatment for the Pyogenic infection of the spine is, 6-8 weeks parenteral antibiotics and continuation of antibiotics orally for appropriate cases. For the Pott disease, antibiotic protocol has been changed in following years but it is still four drugs for the first 6 months and two drug antituberculosis for the second 6 months. The cases on which medical treatment is ineffective and progressive neurological deficiency or segmental instability is seen, should be candidate for surgical treatment.

Anahtar Kelimeler : spondylodiscitis; Pott disease; diagnosis; treatment; low back pain