RESUMO
Since February 1987 percutaneous CT-guided spine biopsy was performed in 18 patients with spondylodiscitis at the X-ray Department of Bispebjerg Hospital. Eleven cases were spontaneous and seven followed spinal surgery. The infection was located in five cases in the thoracic spine and in 13 cases in the lumbar spine. Only one biopsy was performed during general anaesthesia, the rest under local anaesthesia. No complications were observed. The bioptic material was cultivated immediately beside the patient and incubated for 14 days. The infective organism was isolated in 12 cases (67%). Thus, material obtained through a fine needle was satisfactory for microbiological investigation. A biopsy is crucial for establishing a microbiological diagnosis and thereby enabling prompt adequate treatment.
Assuntos
Biópsia por Agulha/métodos , Discite/patologia , Coluna Vertebral/patologia , Vértebras Torácicas/patologia , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Idoso , Ensaio de Unidades Formadoras de Colônias , Discite/diagnóstico por imagem , Discite/microbiologia , Discite/cirurgia , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Coluna Vertebral/diagnóstico por imagem , Coluna Vertebral/microbiologia , Vértebras Torácicas/diagnóstico por imagem , Vértebras Torácicas/microbiologiaRESUMO
A retrospective study of 23 patients with spondylodiscitis is reported. Sixteen cases were spontaneous. Five of these were seen in the acute phase with S. aureus grown from the blood. Eleven patients were investigated with CT-guided biopsy of the spine with identification of different microorganisms in eight cases. In four of seven cases of spondylodiscitis after operation for disc herniation coagulase-negative staphyloccoci were grown after CT-guided biopsy. In spontaneous cases pain disappeared and CRP was normalized within a few weeks after treatment with antibiotics, but radiological changes might progress for several months. Antibiotics were given for two to six months, with a mean of 5.1 months in purulent bacterial infections, and all patients were considered cured after this.