Spondylodiscite

The spondylodiscite , also called discospondylite indicates the Infection of a intervertebral Disque and adjacent vertebral bodies. It is about a medical emergency which requires a fast assumption of responsibility and a long Antibiothérapie (6 to 12 weeks).

Signs of the disease

- Inflammatory Pains of the rachis, worsened not the mobilization, with stiffness and exquisite pain with palpation - Inconstant infectious Signs

Mode of contamination

- Hematogen Way, with the waning of a Bactériémie or a Septicaemia. It is the most frequent mode of contamination - Inocculation direct, with the waning of a lumbar ponstion or an epic surgical.

Bacteriology

In more than 50%, the responsible germ will be the Staphylocoque: - Staphylococcus aureus, especially in the event of contamination by hematogen way. - Staphylococcus aureus, which is seen in the event of direct inocculation (often by the means of infiltations).

Then, in second place, come the negative bacilli grams, reponsable denviron 15% of the spondylodiscites .

The Bacillus of Koch, remains an exceptional cause of spondylodiscites , being seen among patients presenting a advanced Tuberculose (immigrants, immunodéprimés, ect.), being presented under the Mal of Pott

Examinations and analyzes

Standard radiology

One seeks:

pinching of a disc
of the notches on the level of the vertebral plates compared to the disc
an abscess on the level of the soft parts (image in spindle)

The scanner (with injection)

Carried out in a systematic way to make the complete assessment of the lesions and/or to make a puncture of the abscess guided by scanner. One seeks the same signs as in standard radiology.

The IRM

Carried out when the osseous scintiscanning shows a hearth of fixing, but that radiologies standards are normal (often at the beginning of disease). One research same signs as in standard radiology.

Bacteriological analysis of the abscess

Whatever the germ, the signs are the same ones. The bacteriological analysis will make it possible to adapt the treatments according to the found germ.

Evolution of the disease

If it there not of treatment, there is formation of " blocks vertébraux".

Random links: