第7巻 2011年2月　第1号

■症例から学ぶ

化膿性脊椎炎
元文　芳和, 宮本　雅史, 今野　俊介, 須藤　賢太郎, 福田　慶一, 伊藤　博元
日本医科大学大学院医学研究科感覚運動機能再建学

Pyogenic Spondylitis
Yoshikazu Gembun, Masabumi Miyamoto, Shunsuke Konno, Kentaro Sudo, Keiichi Fukuda and Hiromoto Ito
Division for Restorative Medicine of Neuro-muscuroskeletal System, Graduate School of Medicine, Nippon Medical School

Pyogenic spondylitis most often presents with fever and low back pain, and delayed treatment increases the risk of nerve paralysis and vertebral destruction. We report the conditions and treatment plans of 58 patients with pyogenic spondylitis who were admitted to and treated in our department from 1989 through 2005. The patients were 42 men and 16 women with a mean age of 57 years. Most patients had been referred by other departments. The mean time to diagnosis was 48 days, and the mean hospital stay was 106 days. Pyogenic spondylitis most often involved the lumbar spine (36 of 58 patients, 62%). Motor paralysis was frequently observed in patients with cervical or thoracic disease (7 patients [70%] and 6 patients [50%], respectively) but rarely in patients with lumbar disease (1 patient, 3%). About half of the patients underwent surgical procedures, including computed tomography guided puncture, endoscopic puncture, and anterior spinal fusion. Causative organisms were identified with blood culture in 53% of cases and with specimen culture in 68% of cases. Thirteen patients had antecedent infections, and 60% of patients had underlying diseases, such as diabetes mellitus and cancer. It is important for pyogenic spondylitis to be diagnosed and treated early. We feel the need to enlighten orthopedic surgeons and all other physicians about the concept of pyogenic spondylitis.

日医大医会誌 2011; 7(1), 27-30

Key words
compromised host, early diagnosis, magnetic resonance imaging, computed tomography guided puncture, endoscopic puncture

Correspondence to
Yoshikazu Gembun, Division of Restorative Medicine of Neuro-muscuroskeletal System, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku Tokyo 113-8603, Japan
E-mail：ortho@nms.ac.jp

受付：2010年11月30日　受理：2011年1月11日