脊柱感染 课件.ppt

ppt课件ppt课件

SPINEinfectionsandrelated*ppt课件概念累及椎间盘\椎体\附件感染可并发硬膜外脓肿*ppt课件分类PyogenicInfectionsFungalInfectionsTBInfections*ppt课件化脓性感染IncidenceNageletal.(2)8%ofallosteomyelitis.52%ofthepatientswereolderthanage50intravenous(IV)druguse(4).*ppt课件病理基础干骺部丰富静脉丛终末动脉分支椎体和椎间盘延续发展椎间盘分解-狭窄间隙*ppt课件细菌学单一细菌,金葡菌,50%G-,老年人,伴泌尿系感染,IVdrugabusers慢性低毒性感染,凝血酶阴性Staphylococcus,类白喉菌,10days培养期*ppt课件临床表现90%疼痛,压痛\肌痉挛50%;发热,with20%小于3weeks,30%3weeksto3months,and50%超过3monthsduration腰48%,胸35%,颈6.5%,胸\腰骶段Rest.跳跃性4%to5%*ppt课件部分诊断困难不发热血沉,病程指标\白细胞正常病程和诊断时间长,最终活检确诊*ppt课件出现瘫痪危险因素老年平面高糖尿病类风关激素使用*ppt课件影像X-RAYNEGATIVE-----间隙狭窄,软组织阴影,晚期两侧椎体破坏CT:溶骨,椎旁软组织肿胀,产气核素:并不优于MR;儿童\老年人局部缺血灶MR:椎体\椎间盘低T1,T2裂隙消失;增强的椎体和间盘,脓肿不增强*ppt课件影像*ppt课件BiopsyTechniques除了明确影像学\临床\血培养阳性.血培养25%阳性*ppt课件非手术治疗针对性抗生素培养阴性=广谱抗生素6-8周万古,替考拉宁,庆大,妥布,克林可到达头孢\青霉素类浓度低*ppt课件手术治疗活检阴性体温高呈感染性临床表现;保守治疗失败血沉快;持续剧烈疼痛畸形骨破坏影像学进展;神经症状*ppt课件临床病例*ppt课件椎管外脓肿*ppt课件thetitaniummeshcages,etitaniumcagesandPEEKcageswereefficientinprovidinganteriorfusionoftheinfectedspine.therateofsubsidencewashigher,andtheintervaluntilsubsidencewasshorterinthestrutgroupthaninthecagegroup.*ppt课件*ppt课件*ppt课件FungalInfections少见临床症状隐匿开放检出率高*ppt课件TBINFECTIONS3%to4%ofalltuberculousskeletalsystem,50%involvethespine*ppt课件病源学椎体前部85%to90%终板—椎间盘---椎体胸腰段\腰段*ppt课件不同临床类型*ppt课件晚期残留畸形*ppt课件自然病史畸形进展活动期静止期成人\儿童差异*ppt课件儿童结核自然病史*ppt课件CausesofneurologicdeficitinactiveandhealeddiseaseParaplegiaofactivedisease(occurringhoweverlate)

??Compressivepathologycausedby

????Inflammatoryedema

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????Caseoustissueandabscess

????Sequestratedboneanddiscmaterial

??Infectivevasculitis

??Spinaltumorsyndrome

??Pathologicdislocationofthespine

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