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Pyogene Spondylodiszitis

Therapiealgorithmus und neue Klassifikation zur therapeutischen Entscheidungsfindung

Pyogenic spondylodiscitis

Therapy algorithm and a new classification for therapeutic decision-making

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Zusammenfassung

Die Inzidenz der pyogenen Spondylodiszitis ist zwar relativ gering, jedoch in den letzten Jahren stetig steigend. Ein Konsensus bzgl. eines optimalen therapeutischen Managements der pyogenen Spondylodiszitis besteht in der Literatur nicht. Die operative Therapie wird kontrovers diskutiert. Es gibt in der Literatur wenige Angaben zur therapeutischen Entscheidungsfindung und eine darauf basierende Therapiestrategie.

Unsere Klassifikation basiert auf unseren eigenen klinischen Erfahrungen und einer retrospektiven Datenanalyse unter Berücksichtigung des Grades der segmentalen knöchernen Destruktion, des Kyphosegrades und der Instabilität, der epiduralen Beteiligung der Erkrankung und des Vorliegens neurologischer Ausfälle, die für die therapeutische Entscheidungsfindung wichtig sind. Basierend auf unserer Klassifikation kann das therapeutische Vorgehen festgelegt werden.

Abstract

The incidence of pyogenic spondylodiscitis is low but has been steadily increasing in recent years. To date there has been no consensus concerning selection of the appropriate treatment, management and strategies and the recommendations for an operative strategy are still a highly controversial issue. In the literature a few statements have been published concerning therapeutic decision-making in pyogenic spondylodiscitis. The classification given in this article is based on clinical experience and retrospective data analysis considering the degree of segmental bony destruction, grade of kyphosis and instability, epidural involvement of the disease and neurological deficits, which are pivotal for therapeutic decision-making. The therapeutic procedure can be defined based on this classification.

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Akbar, M., Sobottke, R., Lehner, B. et al. Pyogene Spondylodiszitis. Orthopäde 41, 749–758 (2012). https://doi.org/10.1007/s00132-012-1998-4

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