Therapy of spondylodiscitis
Therapy of spondylodicitis
If the infection is severe and shows signs of bacterial growth (high fever, chills) of spondylodiscitis, the focus of the infection must usually be surgically repaired immediately. The decision is made by the doctor on a case-by-case basis.
It is difficult to generalize the procedure. Possible surgical measures for spondylodiscitis include:
- Complete removal of the pus focus (Rinsing, removal of dead tissue, etc.)
- Deposit of Antibiotic carriers into the cleaned focus of infection
- Possibly. Injecting the vertebral body with antibiotic cement
- Possibly. Disc replacement surgery (Cages, see Spinal fusion)
- Possibly. Vertebral body stabilization and relief through a bridging stiffening of the spinal column section
- Possibly. Vertebral body replacement surgery
Before, but at the latest after the operation, therapy with a bacteria-killing drug (Antibiotic) recorded.
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My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
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The spine is difficult to treat. On the one hand it is exposed to high mechanical loads, on the other hand it has great mobility.
The treatment of the spine (e.g. herniated disc, facet syndrome, foramen stenosis, etc.) therefore requires a lot of experience.
I focus on a wide variety of diseases of the spine.
The aim of any treatment is treatment without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.
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If the disease is less acute and the diagnosis is early, conservative therapy can be used Spondylodiscitis be enough. The decisive factor in therapy is that an antibiotic that is sensitive to the type of bacteria is administered for a sufficiently long time. In order to determine the type of bacteria, the targeted puncture of the focus of the infection is necessary. This can be done with an imaging method e.g. Computed Tomography or with a mobile X-ray machine (X-ray imager) take place in a controlled manner. The sample obtained in this way is sent for bacteriological examination. Unfortunately, the germ detection does not succeed in every case.
Before the result of the bacteriological examination is available, a wide-ranging must be carried out Administration of antibiotics to be started. Broad spectrum antibiotics, which have a particularly large spectrum of germs, i.e. are able to kill many of the common types of bacteria, are suitable for this purpose. Usually several different antibiotics have to be given at the same time in order to prevent the infection from spreading as safely as possible.
Antibiotic therapy for spondylodiscitis is used at the beginning of therapy vein (intravenous (i.v.) = as a drip (infusion), because this is expected to make the drug more effective. Some antibiotics can only be given intravenously because they are not absorbed through the gastrointestinal tract or they would be destroyed. Is the infection "under control" i.e. If the inflammation values continue to decline, the therapy can be switched to an oral antibiotic. Overall, antibiotic therapy often extends over months. Regular controls of the inflammation parameters are necessary. Because antibiotics also cause damage Kidneys or the liver can lead, the "kidney and liver values" must also be regularly determined in the blood.
Another principle in the treatment of inflammation is immobilization (Retention) the affected region. In the case of spondylodicitis, depending on the severity of the inflammation, this can be done with a plaster corset or a factory-made corset. In addition, there is at least temporary bed rest or restricted bed rest (the patient is allowed to go to the toilet).
