Nonspecific bacterial spondylitis--an analysis of 32 cases

Abstract

With the decrease of tuberculous spondylitis non-specific bacterial spondylitis has got more importance. Regarding the difficult differential diagnosis between non-specific spondylitis, tuberculous spondylitis and tumor the question arises about the role of primary surgical procedure. 32 cases of the orthopedic departments of Brno and Lübeck are demonstrated, in whom surgical intervention has been chosen without exception (exposure with or without spondylodesis). In 19 cases the bacteriological and in all cases the histological findings ensured the diagnosis "non-specific bacterial spondylitis". Diagnostic proceedings corresponded to the descriptions in literature, x-rays (incl. tomograms) and scintigraphy had superior importance, CT had to show the expansion of the inflammatory process into the vertebral canal. Concerning diagnosis, course of disease and duration of therapy blood sedimentation rate and leucocyte count were the dominant parameters. Time of bed-rest and corset-wearing depends on clinical and laboratory findings, antibiotic treatment should be continued until mobilisation and normalisation of clinical and laboratory findings. In one case we had a grave complication during the operation (lesion of v. iliaca), apart from this healing up occurred in all cases within one year, in the course of which radiological stabilisation followed normalisation of clinical and laboratory parameters.