I-Spondylodiscitis ukutheleleka okunzima kwe-vertebrae eyodwa noma ngaphezulu kanye nama-intervertebral discs aseduze. Ingenye yezimbangela eziningi zobuhlungu beqolo nomgogodla. Okungavamile, lesi simo simelela u-2 kuya ku-7% wezifo ze-osteoarticular. Kwezinye izimo, i-spondylodiscitis ibangela ukucindezelwa komgogodla ngenxa yethumba. Lokhu kungafinyelela futhi kucekele phansi izimpande zezinzwa. Ngakho-ke kubalulekile ukwelapha lesi sifo ngokushesha ukuze ugweme izinkinga zesikhathi eside. Ukuphatha kuhlanganisa ukuvinjelwa ngokuphumula kombhede kanye / noma i-immobilization orthosis, kanye nokwelashwa okufanelekile kwama-antibiotic.

Igama elithi spondylodiscitis livela kumagama esiGreki ama-spondulos okusho ukuthi i-vertebra ne-discos okusho idiski. Kuyisifo sokuvuvukala kwe-vertebrae eyodwa noma ngaphezulu kanye nama-intervertebral discs aseduze.

I-spondylodiscitis esithathelwanayo yisimo esingavamile. Imele u-2 kuya ku-7% we-osteomyelitis, okusho ukuthi izifo ze-osteoarticular. Kuthinta icala eli-1 ngonyaka eFrance, okungcono abesilisa. Uma isilinganiso seminyaka yokuqala sineminyaka engaba ngu-200, ama-60% eziguli angaphansi kweminyaka engama-50, i-spondylodiscitis ehlasela kakhulu intsha. Phakathi nalezi zikhathi ezimbili zokuphila, izinguquko emathanjeni zibaluleke kakhulu, okwenza kube sengozini enkulu engozini yokutheleleka. Kuyisifo esiyingozi esiveza izingozi zokukhubazeka komgogodla kanye ne-neurological sequelae. 

Ukutheleleka kuvame ukwenzeka ngegazi elilandela i-sepsis. Amagciwane ahilelekile ngokuvamile yilawa amagciwane alandelayo: 

• pyogens, njenge Staphylococcus i-aureus (ibhaktheriya ekhonjwe ku-30 ​​kuya ku-40% wamacala), i-Gram-negative bacilli efanaEscherichia coli (20 kuya ku-30% amacala) kanye I-Streptococcus (10% wamacala);
• I-Mycobacterium isifo sofuba (kulokhu sikhuluma ngesifo sikaPott);
• I-Salmonella;
• Brucelles.

Okungavamile, igciwane kungaba ukhunta ezifana ama-candida albicans

Nakuba isifo sofuba sitholakala ikakhulukazi esifundeni se-thoracic, i-spondylodiscitis ethathelwanayo ye-pyogenic ithinta:

• umgogodla we-lumbar (60 kuya ku-70% wamacala);
• umgogodla we-thoracic (23 kuya ku-35% wamacala);
• umgogodla wesibeletho (5 kuya ku-15%);
• izitezi ezimbalwa (9% wamacala).

I-spondylodiscitis ethathelwanayo ingavela ngenxa yalokhu:

• umchamo, amazinyo, isikhumba (inxeba, i-whitlow, ithumba), i-prostate, inhliziyo (i-endocarditis), ukutheleleka kokugaya noma i-pulmonary;
• ukuhlinzwa komgogodla;
• ukubhoboza i-lumbar;
• inqubo yendawo engenele kancane yokuxilongwa (i-discography) noma yokwelapha (ukungena kwe-epidural).

Ngokuya ngegciwane, izindlela ezimbili zokuziphendukela kwemvelo zingahlukaniswa:

• inkambo eyingozi uma kwenzeka amagciwane e-pyogenic;
• inkambo engapheli ezimeni zesifo sofuba noma izifo ze-pyogenic eziphathwa ngokwelashwa okunganele kwama-antibiotic.

Isici esiyinhloko esiyingozi ukuguqulwa kwesimo somzimba wesiguli. Ngaphezu kwalokho, ngaphezu kwe-30% yeziguli ezinesifo sikashukela, cishe i-10% ibangelwa ukuphuza utshwala okungapheli futhi cishe i-5% inesinye salezi zifo ezilandelayo: 

• Umdlavuza;
• i-hepatic cirrhosis;
• isifo sezinso sokuphela kwesigaba;
• isifo sesistimu.

I-spondylodiscitis esithathelwanayo ingenye yezimbangela eziningi zobuhlungu beqolo, okuwubuhlungu obujulile emhlane nasemgogodleni. Angahlotshaniswa nalokhu:

• ukuqina okukhulu komgogodla;
• i-nerve irradiations ebuhlungu: i-sciatica, i-cervicobrachial neuralgia;
• imfiva (ngaphezu kwezingxenye ezimbili kwezintathu ze-spondylodiscitis ye-pyogenic) nokubandayo;
• ubuthakathaka nokucindezelwa kwama-vertebrae;
• ukuwohloka kwesimo esijwayelekile.

Kwezinye izimo, i-spondylodiscitis esithathelwanayo ingabangela ukutheleleka kwe-meninges noma ukucindezelwa komgogodla ngenxa yethumba. Lokhu kungafinyelela futhi kucekele phansi izimpande zezinzwa.

Ngokuya ngokubaluleka kokutheleleka kanye nohlobo lwamabhaktheriya, imiphumela yakamuva ingase yenzeke njenge-vertebral block, okusho ukuthi ukushiselwa kwama-vertebrae amabili aphikisanayo.

I-spondylodiscitis ethathelwanayo iyisimo esiphuthumayo sokwelapha esidinga ukulaliswa esibhedlela. Usekelo luhlanganisa:

Ukungakwazi ukuhamba embhedeni

• igobolondo eliphonswe noma i-corset ingasiza ukuzolalisa ubuhlungu obunzima futhi ivimbele ukukhubazeka okubangelwa ukucindezelwa kwe-vertebral, ikakhulukazi esimweni sesifo sikaPott;
• kuze kube yilapho ubuhlungu buphelile esimweni se-pyogenic spondylodiscitis (izinsuku ezingu-10 kuya kwezingu-30);
• izinyanga ezingu-1 kuya kwezingu-3 esimweni sesifo sikaPott.

Ukwelashwa okuqinile okuhlala isikhathi eside okuhambisana negciwane

• ezifweni ze-staphylococcal: inhlanganisela ye-cefotaxime 100 mg / kg kanye ne-fosfomycin 200 mg / kg bese inhlanganisela ye-fluoroquinolone - rifampicin;
• ngezifo zemvelaphi yasesibhedlela ezimelana ne-methicillin: inhlanganisela vancomycin - fucidic acid noma i-fosfomycin;
• Ukutheleleka kwe-bacilli e-gram-negative: inhlanganisela ye-cephalosporin yesizukulwane sesithathu ne-fosfomycin, i-cephalosporin yesizukulwane sesithathu ne-aminoglycoside noma i-fluoroquinolone ne-aminoglycoside;
• Esimeni se-Pott's disease: i-quadruple anti-tuberculosis antibiotic therapy izinyanga ezi-3 bese kuba yi-bichimotherapy ezinyangeni eziyi-9 ezilandelayo.

Ukuhlinzwa ezimweni ezingavamile

• i-laminectomy ye-decompressive ezimweni zokucindezelwa komgogodla okungazelelwe;
• ukukhishwa kwethumba le-epidural.

 Isifundo ngokuvamile siyavumelana. Imfiva nobuhlungu obuzenzakalelayo ngokuvamile kuyaphela phakathi kwezinsuku ezi-5 kuya kweziyi-10. Ubuhlungu bemishini ngaphansi komthwalo buyanyamalala phakathi nezinyanga ezi-3.