Spondylodiscitis chirwere chakakomba cheimwe kana akawanda vertebrae uye ari pedyo intervertebral discs. Ndicho chimwe chezvikonzero zvakawanda zvekurwadziwa kwemusana uye musana. Kazhinji, chirwere ichi chinomiririra 2 kusvika 7% ye osteoarticular infections. Mune zvimwe zviitiko, spondylodiscitis inokonzera kudzvinyirirwa mumuzongoza nekuda kweabscess. Izvi zvinogona kusvika nekuparadza midzi yetsinga. Saka zvakakosha kurapa iyi pathology nekuchimbidza kudzivirira matambudziko akareba. Iwo manejimendi anosanganisira immobilization nekuzorora pamubhedha uye / kana immobilization orthosis, uye yakakodzera mishonga inorwisa mabhakitiriya.

Izwi rokuti spondylodiscitis rinobva pamazwi echiGiriki spondulos zvinoreva vertebra uye discos zvinoreva dhisiki. Icho chirwere chinoputika cheimwe kana akawanda vertebrae uye ari pedyo intervertebral discs.

Infectious spondylodiscitis chirwere chisingawanzoitiki. Inomiririra 2 kusvika ku7% ye osteomyelitis, kureva zvirwere zve osteoarticular. Inobata nyaya 1 pagore muFrance, zviri nani varume. Kana avhareji yezera rekutanga iri makore 200, 60% yevarwere vari pasi pemakore makumi mashanu, spondylodiscitis inonyanya kubata vechidiki. Munguva idzi mbiri dzehupenyu, kuchinja kwemapfupa kunonyanya kukosha, zvichiita kuti kuve nekusagadzikana kukuru kune ngozi yehutachiona. Icho chirwere chakakomba chinopa njodzi dzekuremara kwemusana uye neurological sequelae. 

Kusvibiswa kunowanzoitika kuburikidza neropa rinotevera sepsis. Utachiona hunobatanidzwa kazhinji kazhinji hunotevera mabhakitiriya: 

• pyogens, zvakadai Staphylococcus aureus (mabhakitiriya anowanikwa mu30 kusvika ku40% yezviitiko), Gram-negative bacilli yakadai secoli coli (20 kusvika 30% yematambudziko) uye streptococcus (10% yezviitiko);
• Mycobacterium tuberculosis (munyaya iyi tinotaura nezvechirwere chePott);
• Salmonella;
• Brucelles.

Zvizhinji kashoma, hutachiona hunogona kuve fungus senge candida albicans

Nepo tuberculosis inonyanya kuwanikwa munharaunda ye thoracic, infectious pyogenic spondylodiscitis inobata:

• iyo lumbar spine (60 kusvika 70% yezviitiko);
• iyo thoracic musana (23 kusvika 35% yezviitiko);
• cervical musana (5 kusvika 15%);
• akati wandei pasi (9% yemakesi).

Infectious spondylodiscitis inogona kuitika kubva kune:

• urinary, mazino, ganda (ronda, whitlow, boil), prostate, cardiac (endocarditis), chirwere chekudya kana chemapapu;
• kuvhiyiwa kwemusana;
• kuputika kwechiuno;
• nzira shoma yemunharaunda yekuongorora (discography) kana kurapa (epidural infiltration).

Zvichienderana nehutachiona, nzira mbiri dzekushanduka-shanduka dzinogona kusiyaniswa:

• nzira yakaoma kana yepyogenic bacteria;
• kosi isingaperi muzviitiko zvetibhii kana pyogenic zvirwere zvinorapwa nekusakwana kwemishonga inorwisa mabhakitiriya.

Chinhu chikuru chine njodzi kuchinjwa kwemuviri wemurwere. Mukuwedzera, vanopfuura 30% yevarwere vane chirwere cheshuga, vakakomberedza 10% kubva kune chidhakwa chisingaperi uye vanenge 5% vane imwe yeinotevera pathologies: 

• Cancer;
• hepatic cirrhosis;
• kuguma-danho renal chirwere;
• systemic chirwere.

Infectious spondylodiscitis chimwe chezvikonzero zvakawanda zvemarwadzo ekudzokera shure, iyo inorwadza zvikuru mumusana uye musana. Vanogona kubatanidzwa ne:

• kuoma kwepelinha kwakanyanya;
• kurwadza kwetsinga irradiations: sciatica, cervicobrachial neuralgia;
• fever (mune zvinopfuura zvikamu zviviri kubva muzvitatu zvezviitiko zve pyogenic spondylodiscitis) uye chills;
• kupera simba uye kudzvinyirira kwe vertebrae;
• kuderera kwemamiriro ezvinhu.

Mune zvimwe zviitiko, spondylodiscitis inotapukira inogona kukonzera hutachiona hwemeninges kana kudzvanywa kwemutsipa wepelinha nekuda kweabscess. Izvi zvinogona kusvika nekuparadza midzi yetsinga.

Zvichienderana nekukosha kwehutachiwana uye rudzi rwebhakitiriya, mhedzisiro inogona kuitika senge vertebral block, kureva kusungirirwa kwemaviri akatarisana.

Infectious spondylodiscitis inguva yekurapa inoda kuchipatara. Kutsigira kunosanganisira:

Immobilization pamubhedha

• ganda rakakandwa kana corset inogona kubatsira kudzikamisa marwadzo akanyanya uye kudzivirira kuremara kunokonzerwa ne vertebral compression, kunyanya panyaya yePott's disease;
• kusvikira marwadzo apera munyaya ye pyogenic spondylodiscitis (10 kusvika kumazuva makumi matatu);
• kwemwedzi 1 kusvika ku3 munyaya yechirwere chePott.

Mushonga unorwisa mabhakitiriya unogara kwenguva refu wakachinjirwa kuutachiona

• kune staphylococcal zvirwere: musanganiswa cefotaxime 100 MG/kg uye fosfomycin 200 MG/kg ipapo musanganiswa fluoroquinolone – rifampicin;
• nokuda kwezvirwere zvechipatara zvinopikisa methicillin: musanganiswa vancomycin - fucidic acid kana fosfomycin;
• Kune gram-negative bacilli zvirwere: kusanganiswa kwechizvarwa chechitatu cephalosporin uye fosfomycin, 3rd generation cephalosporin uye aminoglycoside kana fluoroquinolone uye aminoglycoside;
• Kana paine chirwere chePott: quadruple anti-tuberculosis antibiotic therapy kwemwedzi mitatu then bichimotherapy kwemwedzi mipfumbamwe inotevera.

Kuvhiya mumamiriro ezvinhu akasiyana

• decompressive laminectomy muzviitiko zvekamwe kamwe spinal cord compression;
• kubuda kwe epidural abscess.

 Kosi yacho inowanzova yakanaka. Fivha nemarwadzo ega ega zvinowanzopera mukati memazuva mashanu kusvika gumi. Mechanical pain pasi pemutoro inopera mukati memwedzi ye5.