GRUSS, P and TANNENBAUM, H and OTTTANNENBAUM, B and MEGELE, R and TASLER, J and SPOHR, A and GERHART, G and GUSSMANN, S (1992) THE COURSE OF SPONDYLODISCITIS AFTER DISCECTOMY - GENESIS, TREATMENT AND PREVENTION. NEUROCHIRURGIA, 35 (3). pp. 79-84. ISSN 0028-3819,
Full text not available from this repository.Abstract
Operations on lumbar disc prolapses are the most frequent operations in German neurosurgery divisions. After such operations, spondylodiscitis is a dreaded complication which is sometimes difficult to diagnose. treatment of spondylodiscitis is always protracted and a burden for doctors and patients. Hence, it appears worthwhile to present a further report on discitis and spondylodiscitis, infections of the intervertebral space and the surrounding tissues after disk operations. Various clinical pictures are described: septic progress forms with neurological disorders and the necessity of open wound treatment as well as clinical pictures without septic signs with good recovery after immobilisation and antibiotic treatment. In two cases, CT-guided puncture of purulent suppuration with identification of the causative organisms and specific antibiotic treatment was possible. All patients had a relatively good result: pareses and/or bladder/rectal disorders disappeared completely in every case. The causes of discitis are discussed. The condition arises when nosocomial microorganisms, or very frequently even harmless skin bacteria, enter the wound. A large number of operations are carried out under pressure of time and under hectic conditions, as well as in a confined space in operation theatres which are too warm; these factors increase the susceptibility to infection. However, the resistance of the patient to infection is also weakened after longterm prior anti-inflammatory treatment and a stay in hospital before the operation. Besides appropria to treatment of the infection (immobilisation, wound treatment, antitiotic therapy), psychological management of the patient is an important component of therapy. An unhurried surgical procedure which is as nontraumatic as possible with meticulous observance of sterility with regard to the surgeon's own hands, the patient's skin, the surgical drapes etc., will help to avoid discitis. In our clinical experience, a single dose of an antibiotic active against cocci applied at the beginning of the operation may be useful to reduce the number of discitis cases. The fact that we were always able to demonstrate an effective level of the applied antibiotic in the blood of the cleared intervertebral space (as showed in our tables) is consistent with this experience.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | DISCITIS; DISKECTOMY; SPONDYLODISCITIS; NOSOCOMIAL INFECTION |
| Depositing User: | Dr. Gernot Deinzer |
| Last Modified: | 19 Oct 2022 08:44 |
| URI: | https://pred.uni-regensburg.de/id/eprint/54560 |
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