Отдаленные результаты консервативного лечения остеомиелита позвоночника

Abstract

The purpose of this study was to analyze long-term results of conservative treatment of patients with osteomyelitis of the spine. The authors examined 135 patients with osteomyelitis of the spine. Conservative treatment was made in 67 (50%) patients, other patients was carried out surgical treatment. Indications for treatment included: early diagnosis of the disease, the absence of sig-nificant lesions destruction of vertebral bodies, neurological complications, the presence of comorbidity and organ failure. The complex conservative treatment consisted of: antibacterial and detoxification therapies, orthopedic immobilization, immune-corrective and tonic medicines. In the preoperative and long-term period (time from 1 year to 15 years after surgery) the clinical, paraclinical, radiation methods and classification developed by Frankel H.L.et al (1969) were used for evaluation of neurological disorders. Long-term results included assessment of pain on VAS and quality of life questionnaire developed by Oswestry and SF-36. For statistical analysis of the material was used the software package Statistica 6.1 (license agreement BXXR006B092218FAN11). Long-term clinical, laboratory and x-ray methods didn’t shown recurrence of the disease. In 16 patients with neurological complications after treatment, regression of neurological symptoms was revealed. Pains in the spine, associated with symptoms of degenerative disc disease without neurological deficit, were established in some patients. At most patients the presence of spontaneous fibrous or bone block is marked at the level of former inflammatory process with symptoms of degenerative disc disease in the lower divisions. All patients returned to their previous jobs in terms from 6 to 12 months after the treatment. Thus, the authors concluded that conservative treatment of the patients with osteomyelitis of the spine is defensible, harmless and effective method in particular indicated cases.