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椎体强化术术后感染诊断和治疗进展
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Abstract:
椎体强化术(经皮椎体成形术或经皮脊柱后凸成形术)术后感染(Spinal infection after vertebra augmentation, SIAVA)是罕见但严重的手术并发症，结核分枝杆菌、金黄色葡萄球菌等多种病原微生物都可能引起手术节段椎体的感染，胸椎、腰椎均可受累。主要表现为责任节段的化脓性脊柱炎或脊柱结核。患者往往有腰背疼痛、活动受限，伴或不伴有神经功能障碍、发热等症状。神经功能缺损、瘫痪甚至死亡等结局是SIAVA的严重后果，准确、及时的诊断以及适当治疗方式可以改善患者的结局。本文对SIAVA的病因、临床表现、辅助检查、治疗方法等研究的目前进展做出以下综述。
Spinal infection after vertebral augmentation (SIAVA), including percutaneous acrylic vertebroplasty or percutaneous kyphoplasty, is a rare but severe postoperative complication. Pathogens such as Mycobacterium tuberculosis and Staphylococcus aureus can lead to infections in the treated vertebral segments, which may involve the thoracic or lumbar spine. The primary manifestations include pyogenic spondylitis or spinal tuberculosis at the affected vertebral segments. Patients often present with low back pain, restricted mobility, and may exhibit neurological deficits, fever, or other symptoms. Severe outcomes such as neurological impairment, paralysis, or even death may occur. Accurate and timely diagnosis combined with appropriate treatment can improve patient outcomes. This article reviews the current advancements in understanding the etiology, clinical manifestations, diagnostic approaches, and therapeutic strategies for SIAVA.
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