Spondylodiscitis of the spine: what is it, symptoms, treatment, antibiotics
Spondylodiscitis of the spine is a disease in which there is an inflammatory process in the vertebrae and intervertebral discs. The reason for the development of spondylolisthesis are degenerative-dystrophic processes in the spine, with subsequent inflammation and accession bacterial infections. The treatment is carried out by physician neurologist.
The content of the article
Wear of the intervertebral discs initially leads to the appearance of the protrusions, and then repair. Observed innervation of bacteria affected area, impaired circulation. Due to the pressure on the cartilage, exposure of bacterial infections, and also lack of nutrition and oxygen starts the process of inflammation in the spine. The discs are composed of cartilage, and it contains no blood vessels, but the injury of the annulus bacteria open access purposee core. This hematogenous route of infection.
A colloidal solution, which comprises the core is a breeding ground for bacteria. In hematogenic way of infection adjacent vertebrae may also be infected.
Most cases of spondylodiscitis is the result of complications after surgery, the most common localization is lumbar spine. Among men, the disease occurs much more frequently Significantly increases the risk of disease, diabetes, HIV infections. As well as the abuse of alcohol and drugs.
Syptomatic of spondylodiscitis is expressed in the following points:
- Weight loss and lack of appetite, sometimes vomiting;
- Sweating, weakness, sleep disturbance;
- Fever 37 – 38gradusov
- Back pain of various intensity and character;
- Paralysis, paresis, dysfunction of the excretory organs of the pelvis.
This state may last from weeks to months, even with medical care. When spondylodiscitis of the spine, treatment should be stationary.
In the study of the history of the disease in the first place installed previous disease of the spinal column, the fact of carrying out operations or invasive diagnostics. Mandatory testing will also be scheduled for MRI or x-ray. In rare cases assigned to take lumbar puncture, to accurately detect the presence of pus in the spinal fluid.
For spondylodiscitis characteristic changes in the following indicators:
- Elevated erythrocyte sedimentation rate;
- The increase in the concentration of C-active protein.
X-rays do not provide clear images of soft tissues and fluids. The photographs of x-rays formation of abscesses, purulent fusion is determined by the distortion of the shape of the vertebrae, the degree of blurring of contours zamechatelnyh records. The most effective instrumental method for the diagnosis of spondylodiscitis is an MRI. Bone structure not visible in the pictures and appear as black spots. Soft tissues depending on their density, are well recognizable in the images, which allows time to detect infiltration and nodular formation.
In the process of development of the disease inflammation will have aseptic nature timely diagnosis and treatment helps to avoid purulent foci. Quite often aseptic spondylodiscitis in the initial stages is confused with manifestations of degenerative disc disease last stages and spondylitis (an exception are post-operative cases).
Chronic diseases of internal organs are the source of infection, where pathogenic microorganisms gain access into the spine. The result may appear purulent lesions, as a consequence in parallel, such diseases – sepsis, osteomyelitis.
To purulent spondylodiscitis hematogenous route can result in:
- Prostatitis in men, oophoritis (adnexitis) in women;
- Cystitis, pyelonephritis;
- Boils (abscesses in the spine);
- Other infectious diseases of the soft tissues.
Suppurative disease is often observed in the postoperative period as a complication. Spondylodiscitis with purulent lesions can also develop as a result of invasive diagnostic procedures.
- See also: cystitis hurtsloin
Postoperative pathology as the most dangerous, one of the reasons is the deformation of the spine due to damage to the cartilage and bone tissue. The most serious complications are sepsis (osteomyelitis) and inflammation of the spinal cord, they can lead to disability or death.
How to treat
The main objective in acute is during the removal of pain and the inflammatory process. When the diagnosis of spondylodiscitis in patients undergoing surgery for hernia, performed to drain, necessarily assigned to immobilization for a period of 1-3 months.
A neurologist needs to prescribe several different drugs in groups:
- Antibiotics (if the infection, you are assigned a narrow antibiotics, in other cases, the funds are broad-spectrum);
- Analgesics (oxazol, tramadol);
- Muscle relaxants (to eliminate muscle spasms prescribed roxanol, mydocalm);
- Anti-inflammatory drugs (ibuprofen, diclofenac).
It should be noted that the doses of antibiotics are quite large. Also doctor may prescribe procaine or hormonal blockade, first relieve the pain and the inflammation, the second is assigned only in extreme cases. After 2-4 weeks of intensive therapy with positive dynamics of tests, doctors prescribe chondroprotectors and anti-inflammatory nonsteroidal means. Also patient prescribed vitamins and Immunostimulants.
In case of significant injuries of the vertebrae and intervertebral discs, and failure of conservative treatment, as well as exactly prescribed by the septic tissue is assigned to the operation. Operations of this kind are conducted by neurosurgeons. Abscess drained, necessarily produced the purification of the vertebrae, discs and muscles of necrotic tissue. Is nerve decompression sections, and stabilization of the involved segments of the spine. Drug treatment administered from the same dosage groups as the conservative. Prescribed medications are administered intravenously for 4-6 weeks.
- See also: Spondylosis of the lumbar spine.
Additionally, patients are assigned drugs against intoxication. In the case of neurological pathologies of the pelvis (problems with urination, incontinence of urine and faeces), the patient is prescribed the dropper with metronidazole, or used other drugs from the same group.
Prevention of the disease
After the time of immobilization, the spine doctor prescribes fizioterapevticheskoe treatment, uzt, acupuncture. Typically, the patient undergoes several cycles of recovery. A special diet is prescribed, obligatory cessation of Smoking. Prolonged restriction of motor activity leads to muscle atrophy, a return to normal life is gradually, and in some cases takes up to six months.
Temporary shown wearing a corset especially in the early stages of reconstruction of the atrophied muscles, and later is assigned to physical therapy and swimming.
For patients with spondylodiscitis, spine select an individual set of exercises for continuous performance. Strengthened muscle corset prevents compression of the intervertebral discs. Strong physical exertion is contraindicated, it is desirable to avoid hypothermia at the time of treatment and rehabilitation.