微生物频谱,患者特异性因素,以及与植入物相关的术后脊髓瘤的诊断
Lorenz Pichler1, Zhao Li1, Thilo Khakzad1
1Center for Musculoskeletal Surgery Charité - Universitätsmedizin Berlin, Berlin, Germany.
Bone & joint open
|November 2, 2023
概括
植入物相关的术后脊髓炎 (IPOS) 是一种严重的脊髓感染. 这项研究详细介绍了32例IPOS病例,确定了风险因素和治疗结果,强调了手术干预和MRI等诊断方法.
科学领域:
- 脊柱外科手术 脊柱外科手术
- 传染性疾病 传染性疾病
- 整形外科手术 整形外科手术
背景情况:
- 植入物相关的术后脊椎炎 (IPOS) 是脊椎手术的严重并发症,与显著的发病率和死亡率有关.
- 对周围假肢关节感染 (PJI) 的越来越多的了解需要对脊柱植入物感染进行类似的研究.
- 这项研究呈现了迄今为止最大的IPOS病例系列.
研究的目的:
- 描述迄今为止最大的IPOS病例队列.
- 为了确定IPOS的风险因素,临床表现和微生物学发现.
- 评估IPOS的治疗策略和结果.
主要方法:
- 在2006年1月至2020年12月期间,对32名IPOS患者进行了回顾性分析.
- 包括患者人口统计,临床数据,放射性成像 (CT和MRI) 和微生物学结果.
- 通过CT导向活检,手术内抽样或植入物超声波识别病原体.
主要成果:
- 分析了32名患者的队列,平均年龄为68.7岁.
- 确定的危险因素包括糖尿病,60岁以上的年龄,以及以前的感染史.
- 格拉姆阳性菌是最常见的病原体;84.4%的患者接受了脱bridement,压缩和融合.
结论:
- IPOS很罕见,但与自发性脊髓瘤炎具有共同的特征.
- CT导向活检和超声波是有用的诊断工具,MRI和手术内采样是黄金标准.
- 对脊柱感染的植入物管理策略 (保留与交换) 需要进一步的研究,与PJI管理原则进行并行.
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