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Osteologie 2017; 26(04): 211-218
DOI: 10.1055/s-0038-1628300
Osteomyelitis
Schattauer GmbH

Die bakterielle unspezifische “pyogene” Spondylodiszitis

Pyogenic spondylodiscitis
C.-E. Heyde
1   Klinik und Poliklinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Bereich Wirbelsäulenchirurgie, Universitätsklinikum Leipzig AöR, Leipzig
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Further Information

Publication History

eingegangen: 05 September 2017

angenommen: 22 September 2017

Publication Date:
24 January 2018 (online)

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Zusammenfassung

Aus einer Reihe von Gründen nimmt die Häufigkeit der unspezifischen bakteriellen ,,pyogenen“ Spondylodiszitis zu. Verschiedenste Risikofaktoren und Komorbiditäten erhöhen das Erkrankungsrisiko. Trotz verbesserter und z. T. standardisierter Diagnosealgorithmen erfolgt die Diagnose häufig mit einer gewissen Verzögerung. Je nach Befund und Allgemeinzustand ist eine konservative oder operative Therapie abzuwägen. Eine, wenn möglich gezielte und ausreichend lange Antibiotikatherapie ist obligat, dabei kommt einem Erregernachweis eine hohe Bedeutung zu. Das Ziel der Therapie ist eine Ausheilung der Infektion bei einer gut belastbaren, schmerzarmen bzw. schmerzfreien Wirbelsäule ohne neurologische Defizite. Dafür gibt es heute eine Reihe therapeutischer Ansätze. Trotzdem ist die Erkrankung mit einer erhöhten Mortalität und einer relevanten Morbidität verbunden.

Summary

Caused by several reasons the prevalence of nonspecific "pyogenic" spondylodiscitis increased in the last few decades. In spite of improved diagnostic procedures and partially standardized diagnostic algorithms the diagnosis is often established with a delay. Conservative as well as operative treatment is possible depending on local findings and patients general condition. Targeted and sufficiently long antibiotic therapy is mandatory. Therefore, pathogen identification plays an important role. The goal of treatment is complete healing of the infection with a resilient and pain free spine without neurologic deficits. Different therapeutic approaches are available; nevertheless, this disease is still associated with increased mortality and relevant morbidity.

Schlüsselwörter

Spondylodiszitis - Diagnose - Therapie - Prognose

Keywords

Spondylodiscitis - diagnosis - therapy - prognosis
 

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