Spondylodiscitis ke tšoaetso e matla ea vertebrae e le 'ngoe kapa ho feta le li-intervertebral disc tse haufi. Ke e 'ngoe ea lisosa tse ngata tsa mokokotlo le mokokotlo oa mokokotlo. Ntho e sa tloaelehang, boemo bona bo emela 2 ho 7% ea mafu a osteoarticular. Maemong a mang, spondylodiscitis e baka khatello lesapong la mokokotlo ka lebaka la abscess. Sena se ka fihla le ho senya metso ea methapo. Ka hona, ho bohlokoa ho phekola lefu lena ka potlako ho qoba mathata a nako e telele. Taolo e kenyelletsa ho se tsitse ka ho phomola betheng le / kapa ho thibela orthosis, le kalafo e nepahetseng ea lithibela-mafu.

Lentsoe spondylodiscitis le tsoa ho mantsoe a Segerike spondulos e bolelang vertebra le discos e bolelang disk. Ke lefu la ho ruruha la vertebrae e le 'ngoe kapa ho feta le li-intervertebral discs tse haufi.

Spondylodiscitis e tšoaetsanoang ke boemo bo sa tloaelehang. E emela karolo ea 2 ho isa ho 7 lekholong ea osteomyelitis, ke hore mafu a osteoarticular. E ama linyeoe tse 1 ka selemo Fora, haholo banna. Haeba karolelano ea lilemo tsa ho qala e ka ba lilemo tse 200, 60% ea bakuli ba ka tlase ho lilemo tse 50, spondylodiscitis e ama haholo bacha. Nakong ea linako tsena tse peli tsa bophelo, liphetoho tsa masapo ke tsa bohlokoa haholo, tse bakang ho ba kotsing e kholo ea kotsi ea tšoaetso. Ke lefu le tebileng le hlahisang likotsi tsa ho holofala ha lesapo la mokokotlo le sequelae ea methapo. 

Hangata tšoaetso e etsahala ka mali a latelang sepsis. Hangata likokoana-hloko tse amehang ke libaktheria tse latelang: 

• li-pyogens, joalo ka Staphylococcus aureus (libaktheria tse khetholloang ho 30 ho isa ho 40% ea linyeoe), likokoana-hloko tsa gram-negative tse kangEscherichia coli (20 ho 30% ea linyeoe) le Streptococcus (10% ea linyeoe);
• Lefuba la Mycobacterium (tabeng ena re bua ka lefu la Pott);
• Salmonella;
• Brucelles.

Ka seoelo, kokoana-hloko e ka ba fungus joalo ka candida albicans

Le hoja lefuba le fumanoa haholo-holo sebakeng sa sefuba, tšoaetso ea pyogenic spondylodiscitis e ama:

• lumbar lesapo la mokokotlo (60 ho 70% ea linyeoe);
• mokokotlo oa thoracic (23 ho 35% ea linyeoe);
• lesapo la mokokotlo cervical (5 ho 15%);
• mekato e 'maloa (9% ea linyeoe).

Spondylodiscitis e tšoaetsanoang e ka bakoa ke:

• moroto, meno, letlalo (leqeba, whitlow, lethopa), prostate, pelo (endocarditis), tšoaetso ea tšilo ea lijo kapa ea matšoafo;
• ho buuoa lesapo la mokokotlo;
• ho phunya lumbar;
• mokhoa o fokolang oa sebaka sa sebaka sa ho hlahloba (discography) kapa phekolo (epidural infiltration).

Ho itšetlehile ka likokoana-hloko, mekhoa e 'meli ea ho iphetola ha lintho e ka khetholloa:

• mokhoa o matla ha ho na le libaktheria tsa pyogenic;
• mokhoa o sa foleng maemong a lefuba kapa tšoaetso ea pyogenic e tšoaroang ke phekolo e sa lekaneng ea lithibela-mafu.

Lebaka le ka sehloohong la kotsi ke ho fetoloa ha boemo ba 'mele ba ho itšireletsa mafung. Ntle le moo, bakuli ba fetang 30% ba tšoeroe ke lefu la tsoekere, hoo e ka bang 10% ea botahoa bo sa foleng mme hoo e ka bang 5% ba na le e 'ngoe ea li-pathologies tse latelang: 

• Kankere;
• sebete sa sebete;
• lefu la renal la ho qetela;
• lefu la tsamaiso.

Spondylodiscitis e tšoaetsanoang ke e 'ngoe ea lisosa tse ngata tsa bohloko ba mokokotlo, e leng bohloko bo tebileng mokokotlong le mokokotlong. Li ka amahanngoa le:

• ho satalla ho matla ha lesapo la mokokotlo;
• mahlaseli a bohloko a methapo ea kutlo: sciatica, cervicobrachial neuralgia;
• feberu (ka makhetlo a fetang tse peli ho tse tharo tsa pyogenic spondylodiscitis) le serame;
• ho fokolisa le ho hatella lesapo la mokokotlo;
• ho mpefala hoa boemo bo akaretsang.

Maemong a mang, spondylodiscitis e tšoaetsanoang e ka baka tšoaetso ea meninges kapa khatello ea lesapo la mokokotlo ka lebaka la sekheo. Sena se ka fihla le ho senya metso ea methapo.

Ho itšetlehile ka bohlokoa ba tšoaetso le mofuta oa libaktheria, liphello tsa morao-rao li ka 'na tsa e-ba teng, tse kang lesapo la mokokotlo, ke ho re ho chesoa ha li-vertebrae tse peli tse fapaneng.

Spondylodiscitis e tšoaetsanoang ke tšohanyetso ea phekolo e hlokang ho kena sepetlele. Tšehetso e kenyelletsa:

Ho hloka matla betheng

• khetla kapa corset e ka thusa ho kokobetsa bohloko bo tebileng le ho thibela ho holofala ho bakoang ke khatello ea lesapo la mokokotlo, haholo-holo tabeng ea lefu la Pott;
• ho fihlela bohloko bo felile tabeng ea pyogenic spondylodiscitis (matsatsi a 10 ho isa ho a 30);
• bakeng sa 1 ho likhoeli tse 3 tabeng ea lefu la Pott.

Kalafo e matla ea nako e telele ea lithibela-mafu e ikamahanyang le kokoana-hloko

• bakeng sa tšoaetso ea staphylococcal: motsoako oa cefotaxime 100 mg / kg le fosfomycin 200 mg / kg ebe motsoako oa fluoroquinolone - rifampicin;
• bakeng sa mafu a tsoang sepetlele a hananang le methicillin: motsoako oa vancomycin - fucidic acid kapa fosfomycin;
• Bakeng sa tšoaetso ea gram-negative bacilli: motsoako oa moloko oa boraro oa cephalosporin le fosfomycin, moloko oa boraro oa cephalosporin le aminoglycoside kapa fluoroquinolone le aminoglycoside;
• Ha ho na le lefu la Pott: kalafo ea lithibela-mafu e thibelang lefuba ka makhetlo a mane bakeng sa likhoeli tse 3 ebe bichimotherapy bakeng sa likhoeli tse 9 tse latelang.

Ho buuoa maemong a ikhethang

• decompressive laminectomy maemong a khatello ea lesapo la mokokotlo ka tšohanyetso;
• ho ntsha leqeba la epidural.

 Hangata thupelo e ntle. Feberu le mahlaba a itlelang feela hangata a fela nakong ea matsatsi a 5 ho isa ho a 10. Bohloko ba mechine tlas'a mojaro bo nyamela nakong ea likhoeli tse 3.