Espondilodiscite: revisão de literatura

Abstract

ResumoA espondilodiscite é a junção de osteomielite vertebral, espondilite e discite, sendo causada por vários agentes. O Staphylococcus aureus, Brucella abortus e Mycobacterium tuberculosis são os mais comuns no Brasil, e o reconhecimento dos patógenos é de extrema importância para a definição do tratamento antimicrobiano específico. Os exames de imagem são os exames de escolha para o diagnóstico da espondilodiscite, sendo a ressonância nuclear magnética (RNM) o padrão-ouro para fechar o diagnóstico, além de poder ser utilizado como método avaliativo da eficácia terapêutica. O tratamento conservador é feito com base no uso de antibióticos, uso de órteses e repouso. Já o tratamento cirúrgico consiste na descompressão da coluna, desbridamento da área infectada e fusão vertebral. O seguinte trabalho é uma análise das publicações ligadas ao assunto com o objetivo de esclarecer e elucidar dúvidas sobre um tema ainda pouco estudado no nosso meio neurocirúrgico, evidenciada pela escassez de trabalhos brasileiros nessa área.

Spondylodiscitis with Extensive Spine Involvement—Case Report

“…Spinal infections can be divided into exogenous and endogenous, the former being associated with spinal surgery and trauma episodes in this region, while endogenous infections are associated with an infectious outbreak from a distant site, with hematogenous or lymphatic dissemination to the vertebral bodies. 1,2,4,6 They can be classified as pyogenic (bacterial cause), granulomatous (tuberculosis, brucellosis and fungi) and parasitic, which is rarely observed. [1][2][3] Most infections are bacterial, [1][2][3][4] and the main etiological agent involved is S. aureus, 1,2,[7][8][9] with an incidence in between 30 and 80% of the cases.…”

“…3 and 4). 1,2 Hemocultures were negative. The patient was submitted to a C3-C7 anterior corpectomy with cage fixation, and to a C2-T1 posterior arthrodesis (►Figs.…”

“…Spondylodiscitis consists of an inflammatory process of infectious origin, which primarily affects the intervertebral disc, and spreads to the neighboring vertebral bodies, 1,2 often evolving into osteomyelitis, 3 with associated neurological damage if compression of structures such as nerves and the spinal cord occurs. 1,2 The diagnosis is often late, with an average period of 2 to 6 months between the appearance of the first symptoms and the confirmation of the disease. [1][2][3] Palavras-Chave ► espondilodiscite ► coluna ► osteomielite…”

“…1,2 The diagnosis is often late, with an average period of 2 to 6 months between the appearance of the first symptoms and the confirmation of the disease. [1][2][3] Palavras-Chave ► espondilodiscite ► coluna ► osteomielite…”

“…Thus, laboratory tests and imaging exams play an important role in the diagnosis of spondylodiscitis, as well as in the orientation of the treatment to be followed (conservative or surgical). [1][2][3][4] Most patients evolve with a considerable reduction of neurological deficits prior to treatment, but most persist with some sequelae, mainly sensitive, that reduce their quality of life. 1,2,5 In this case report, we present the picture of a patient with extensive involvement of the vertebral column (six levels) by dissemination of the infection after a surgical procedure in the lower limb.…”