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Algorithmus zur Behandlung tiefer Wirbelsäuleninfektionen und der Spondylodiszitis bei einliegender Instrumentierung

Algorithm for treatment of deep spinal infections and spondylodiscitis with in situ instrumentation

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Zusammenfassung

Aufgrund der gestiegenen Anzahl an Wirbelsäuleneingriffen und insbesondere Spondylodesen, zunehmend auch bei alten oder immunsupprimierten Patienten, werden Wirbelsäulenchirurgen immer häufiger mit dem Problem tiefer Wundinfektionen und/oder Spondylodiszitis bei einliegendem Instrumentarium konfrontiert. Diese teils lebensbedrohlichen Komplikationen stellen den behandelnden Arzt oftmals vor erhebliche Schwierigkeiten, nicht nur in der Diagnostik sondern auch in der operativen Strategiefindung, denn nicht selten ist eine Vielzahl von Eingriffen notwendig, bevor der Infektionsherd saniert ist. Das Ziel dieser Arbeit ist, einen möglichen Algorithmus bzgl. Diagnostik und Therapie zur Beherrschung solcher teils hartnäckiger Infektionen darzustellen.

Abstract

Due to a significant increase in spinal interventions and in particular spinal fusion procedures, also in elderly and immunocompromised patients, spinal surgeons are increasingly confronted with deep wound infections and/or spondylodiscitis with in situ instrumentation. This occasionally life-threatening complication can be a challenge for even the most experienced physician, not only in the initial diagnosis but also when determining the operative treatment strategy. It is not uncommon that patients must undergo several operations before a deep infection is finally under control. The aim of this article is to suggest an algorithm for the diagnostics and management of this very troubling complication.

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  1. Klinik für Orthopädie, Unfall- und Handchirurgie, HELIOS Klinikum Krefeld, Lutherplatz 40, 47805, Krefeld, Deutschland

    C.N. Kraft & M. Fell

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  1. C.N. Kraft
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  2. M. Fell
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Correspondence to C.N. Kraft.

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Kraft, C., Fell, M. Algorithmus zur Behandlung tiefer Wirbelsäuleninfektionen und der Spondylodiszitis bei einliegender Instrumentierung. Orthopäde 41, 51–57 (2012). https://doi.org/10.1007/s00132-011-1841-3

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