흉요추부에 발생한 원발성 추간반염의 치료

Abstract

Objective：The authors report a retrospective analysis of the clinical features and treatment of primary spontaneous discitis in thoracic and lumbar spine in our institute.

Methods : From April 1995 to February 2003, twelve patients with primary spontaneous discitis were treated with conservative and various operative methods. We analyzed the symptoms and signs, labaratory findings, treatment methods and results(Stauffer's clinical result).

Results : The average age of patients with primary spontaneous dicitis was 58years old. Eleven patients out of 12 patients complained severe low back pain and one patient complained lower extremity weakness. Twelve had an elevated serum erythrocyte sedimentation rate(ESR) and eight had an elevated C-reactive protein(CRP). The most common pathogen was the Staphylococcus aureus. Seven patients were conservatively treated with IV antibiotics during 5 weeks. After 5 weeks, symptoms and labaratory findings improved in six patients, one patient was not only controlled with IV antibiotics, so required surgical fusion due to persistent back pain and elevated serum ESR and CRP. The other five patients were treated initially with surgical methods. In all cases, symptoms and signs were controlled without complications or recurrences.

Conclusion : While spontaneous discitis has predominantly been reported in immunocompromised patients, sometimes, the disease also affects older adults. Primary spontaneous discitis is treated with proper antibiotics and surgery.