ʻO Spondylodiscitis kahi maʻi nui loa o hoʻokahi a ʻoi aku o nā vertebrae a me nā disverse intervertebral disk. ʻO ia kekahi o nā kumu he nui o ka ʻeha o ke kua a me ka iwi kuamoʻo. ʻO ka maʻamau, hōʻike kēia ʻano i 2 a 7% o nā maʻi osteoarticular. I kekahi mau hihia, spondylodiscitis ke kumu o ka compression i ka iwi kuamoo ma muli o kahi abscess. Hiki i kēia ke hōʻea a luku i nā aʻa aʻa. No laila he mea nui e mālama wikiwiki i kēia pathology e hōʻalo i nā pilikia lōʻihi. Hoʻopili ka hoʻokele me ka immobilization e ka hoʻomaha moe a me / a i ʻole immobilization orthosis, a me nā lāʻau antibiotic kūpono.

No ka huaʻōlelo Helene ka huaʻōlelo spondylodiscitis spondulos ʻo ia hoʻi ka vertebra a me nā diskos ʻo ia hoʻi ka disk. He maʻi maʻi ia o hoʻokahi a ʻoi aku o nā vertebrae a me nā pā intervertebral e pili ana.

ʻO ka maʻi spondylodiscitis infectious kahi ʻano maʻamau. Hōʻike ia i 2 a 7% o ka osteomyelitis, ʻo ia hoʻi nā maʻi osteoarticular. Pili ia i nā hihia 1 i kēlā me kēia makahiki ma Palani, ʻoi aku ka maikaʻi o nā kāne. Inā ʻo ka makahiki maʻamau o ka hoʻomaka ʻana ma kahi o 200 mau makahiki, 60% o nā mea maʻi ma lalo o 50 mau makahiki, ʻo ka spondylodiscitis ka mea pili i nā ʻōpio. I loko o kēia mau manawa ʻelua o ke ola, ʻoi aku ka nui o nā loli i nā iwi, e hoʻonui ana i ka nāwaliwali i ka makaʻu o ka maʻi. He maʻi nui ia e hōʻike ana i nā makaʻu o ke kīnā ʻole o ke kuamoʻo a me ka neurological sequelae. 

Kū pinepine ka hoʻohaumia ma o ke koko ma hope o ka sepsis. ʻO nā mikena i pili pinepine ʻia i nā bacteria: 

• pyogens, e like me ʻO Staphylococcus aureus (bacteria i ʻike ʻia ma 30 a 40% o nā hihia), Gram-maikaʻi bacilli e like meEscherichia coli (20 a 30% o nā hihia) a Streptococcus (10% o nā hihia);
• Mycobacterium tuberculosis (i kēia hihia e kamaʻilio mākou no ka maʻi o Pott);
• Salmonella;
• ʻO Brucelles.

ʻOi aku ka liʻiliʻi, hiki i ka germ ke lilo i fungus e like me candida albicans

ʻOiai ʻo ka tuberculosis ka mea i loaʻa ma ka ʻaoʻao ʻoi loa, pili ka maʻi pyogenic spondylodiscitis i ka maʻi:

• ke kuamoʻo lumbar (60 a 70% o nā hihia);
• ka iwi kuamoʻo (23 a 35% o nā hihia);
• ka iwi kuamoʻo (5 a 15%);
• he mau papahele (9% o nā hihia).

Hiki ke hopena i ka spondylodiscitis maʻi maʻi mai:

• kahi urinary, niho, ʻili (ʻeha, whitlow, paila), prostate, cardiac (endocarditis), digestive a pulmonary maʻi ʻaʻai;
• ʻoki ʻōiwi;
• he kuʻi lumbar;
• kahi hana kūloko invasive kūloko no ka diagnostic (discography) a i ʻole therapeutic (epidural infiltration).

Aia i ka germ, hiki ke ʻike ʻia nā ʻano evolutionary ʻelua:

• kahi papa koʻikoʻi i ka hihia o nā bacteria bacteria;
• kahi papa maʻi maʻamau i nā hihia o ka tuberculosis a i ʻole nā ​​maʻi pyogenic i mālama ʻia e ka lawa ʻole o ka lāʻau antibiotic.

ʻO ke kumu pilikia nui ka hoʻololi ʻana i ke kūlana pale o ka mea maʻi. Eia hou, ʻoi aku ma mua o 30% o nā mea maʻi e ʻeha i ka maʻi diabetes, ma kahi o 10% mai ka waiʻona mau a kokoke 5% i kekahi o kēia mau pathology: 

• Kanesa;
• cirrhosis hepatic;
• maʻi hōʻeha pae hope loa;
• maʻi ʻōnaehana.

ʻO ka spondylodiscitis infectious kekahi o nā kumu he nui o ka ʻeha o ke kua, ʻo ia hoʻi ka ʻehaʻeha ma ka hope a me ka iwi kuamoo. Hiki iā lākou ke pili pū me:

• ʻoʻoleʻa o ke kuamoʻo;
• nā irradiations ʻehaʻeha: sciatica, cervicobrachial neuralgia;
• fiva (i ʻoi aku ma mua o ʻelua hapakolu o nā hihia o pyogenic spondylodiscitis) a me nā haʻalulu;
• nāwaliwali a me ka kaomi ʻana o ka vertebrae;
• kahi hōʻino o ke kūlana maʻamau.

I kekahi mau hihia, hiki i ka spondylodiscitis infectious ke kumu i ka maʻi o nā meninges a i ʻole ke kaomi ʻana o ka iwi kuamoʻo ma muli o kahi abscess. Hiki i kēia ke hōʻea a luku i nā aʻa aʻa.

Kaukaʻi ʻia i ka nui o ka maʻi a me ke ʻano o nā koʻohune, a laila e hopena ʻia nā hopena ma hope e like me ka poloka vertebral, ʻo ia hoʻi ka hoʻopaʻa ʻana o nā vertebrae ʻelua.

ʻO ka spondylodiscitis infectious kahi maʻi kūpilikiʻi e koi ana i ka haukapila. Kākoʻo pū kekahi:

Immobilization i loko o kahi moe

• hiki i ka pūpū hoʻolei a i ʻole corset ke kōkua i ka hōʻoluʻolu loa i ka ʻehaʻeha a pale i ka deformity i hopena ʻia mai ke kaohi ʻana o ka vertebral, keu hoʻi i ka hihia o ka maʻi o Pott;
• a hiki i ka pau ʻana o ka ʻeha ma ka hihia o pyogenic spondylodiscitis (10 a 30 mau lā);
• no 1 a 3 mau mahina i ka hihia o ka maʻi o Pott.

Hoʻololi ka hopena antibiotic ikaika lōʻihi i ka germ

• no nā maʻi staphylococcal: hoʻohui cefotaxime 100 mg / kg a me fosfomycin 200 mg / kg a laila hoʻohui fluoroquinolone - rifampicin;
• no nā maʻi o ka haukapila i kū i ke kū i ka methicillin: hui pū ʻia vancomycin - fucidic acid a i ʻole fosfomycin;
• No nā maʻi bacilli gram-maikaʻi: hui pū ʻia o cephalosporin a me fosfomycin o ka hanauna 3, cephalosporin a me aminoglycoside a i ʻole fluoroquinolone a me aminoglycoside;
• I ka hanana o ka maʻi o Pott: quadruple anti-tuberculosis antibiotic therapy no 3 mau mahina a laila ka bichimotherapy no 9 mau mahina aʻe.

ʻOki kino ma nā kūlana kūikawā

• laminectomy decompressive i nā hanana o ke kuʻi hope ʻana o ka iwi kuamoʻo;
• ka hoʻoneʻe ʻana i kahi abscess epidural.

 ʻOi aku ka maikaʻi o ka papa. Hele pinepine ke kuni a me ka ʻehaʻeha ma waena o 5 a 10 mau lā. ʻO kaʻeha mīkini ma lalo o ka ukana e nalo i loko o 3 mau mahina.