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KMID : 0361619660010010049
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Journal of the Korean Orthopaedic Association
1966 Volume.1 No. 1 p.49 ~ p.57
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Clinical Observation of Hematogenous Pyogenic Osteomyelitis of the Spine
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鄭淳萬/Chung, Soon-Mhan
金光會/鄭仁熙/Kim, Kwang-Hoe/Chung, In-Hee
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Abstract
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Ten cases of hematogenous pyogenic osteomyelitis of the spine were seen in a total of 436 cases of osteomyelitis during the past thirteen years (from January 1952 to December 1964) at Yonsei University Hospital.
1) The incidence of total osteomyelitis cases was 2.29%.
The incidence was maximum in the the twenty to thirty age groups.
The sex ratio was 2.3 : 1. (Male: Female)
2) The offending organism was the coagulase positive staphylococcus in all cases.
3) The site of infection was. in the lumbar vertebrae in seven cases, thoracic in two and cervical in one.
4) The predisposing factors were unknown in five cases and one case each of trauma, multiple abscess, urinary tract infection, peritonitis and chronic otitis media.
5) The clinical symptoms and signs consisted of acute onset of fever with chill (9. cases), severe back pain (all cases), limitation of spinal motion (all cases), spasm of spinal erector muscles (3 cases), nerve root irritation (3 cases), difficult urination (none), scoliosis (1 case), tenderness over the involved spinous process (all cases), some neurological signs of numbness, weakness or paraplegia (2 cases).
6) The main complications were a draining sinus (4 cases) or abscess formation (4 cases), pyogenic meningitis (none) and paraplegia (2 cases).
7) The roentgenographic findings showed a narrowing of intervertebral disc spaces (9 cases), moth-eaten
irregularity of the involved vertebral margins (5 cases), increased density with some areas of mottled
rare faction of the involved vertebrae (5 cases), bone spur or bridge ´formation between. the involved
vertebrae (3 cases), scoliosis (1 case) and paravertebral abscess formation (4 cases).
8) The laboratory findings showed an elevation of blood sedimentation rate-and some leukocytosis.
9) All cases were treated with surgery followed by antibiotics and rest. The three cases received anterior
spinal interbody fusion with an autogenous bone graft through an anterior approach:
10) In spite of a current trend for the conservative treatment, we performed operations because -of the
complications of draining sinus (4 cases) or abscess formation (4 cases) and paraplegia (2 cases). 11) The immediate results (postoperative 6 months) were satisfactory in all cases.
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