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[Early diagnosis of postoperative discitis]
K P Schulitz1, J Assheuer, L Wiesner
1Orthopädische Klinik Düsseldorf.
Zeitschrift Fur Orthopadie Und Ihre Grenzgebiete
|March 1, 1995
Summary
Postoperative spinal infections, including retrodiscal infection and discitis, are likely when fever exceeds 37°C and C-reactive protein (CRP) levels are above 2.0 mcg/ml five days after surgery. Early diagnosis via MRI and prompt antibiotic treatment can effectively cure these infections.
Area of Science:
- Spinal imaging and diagnostics
- Infectious disease of the spine
Context:
- Postoperative spinal infections pose a significant clinical challenge.
- Early detection and management are crucial for patient outcomes.
Purpose:
- To identify key indicators for probable retrodiscal infection and discitis postoperatively.
- To detail MRI findings indicative of spinal infections.
- To outline effective treatment strategies for spinal infections.
Summary:
- Infection of the retro- and intradiscal space is probable when postoperative temperature exceeds 37°C and C-reactive protein (CRP) is > 2.0 mcg/ml at 5 days.
- MRI revealed characteristic hyperintense band-shaped structures in PS-sequences for retrodiscal infection and intradiscal hyperintensity/enhancement for discitis.
- Diagnosis is aided by comparing pre- and postoperative MRI scans.
- Treatment involves antibiotics (Tobramycin, Clindamycin), bed rest, and plaster cast immobilization.
Impact:
- This study provides clear diagnostic criteria for early detection of spinal infections.
- Effective treatment protocols can lead to successful infection resolution.
- Improved diagnostic and treatment strategies can enhance patient recovery and reduce complications.