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01.03.2004 | Leitthema

Osteomyelitis der Wirbelsäule

verfasst von: PD Dr. E. J. Müller, O. J. Russe, G. Muhr

Erschienen in: Die Orthopädie | Ausgabe 3/2004

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Zusammenfassung

Infektionen der Wirbelsäule kommen selten und eher bei älteren Patienten mit Harnwegsinfekten und Diabetes mellitus vor. Mit der Zunahme von immunsupprimierten Patienten , v. a. bei Drogenabusus oder HIV-Infektion, und von Immigranten aus Ländern der 2. und 3. Welt steigt die Inzidenz von Infektionen an der Wirbelsäule gerade auch bei jüngeren Patienten. Typisch ist nur ein Erreger als Verursacher, mit Staphylococcus aureus als häufigstem bakteriellem Keim. Die Keimbesiedelung erfolgt vornehmlich hämatogen und betrifft initial die endplattennahenAreale des Wirbelkörpers. Bei unspezifischer Klinik sind insbesondere die Kernspintomographie und der mikrobiologische Keimnachweis im Punktat diagnostisch wesentlich. Im Vordergrund der Therapie steht die gezielte Antibiose über mindestens 6–8 Wochen. Eine Indikation zur Op. mit osteosynthetischer Stabilisierung und Spondylodese besteht in der Regel bei neurologischen Ausfällen, knöcherner Instabilität sowie Abszessen.

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Titel: Osteomyelitis der Wirbelsäule
verfasst von: PD Dr. E. J. Müller
O. J. Russe
G. Muhr
Publikationsdatum: 01.03.2004
Verlag: Springer-Verlag
Erschienen in: Die Orthopädie / Ausgabe 3/2004
Print ISSN: 2731-7145
Elektronische ISSN: 2731-7153
DOI: https://doi.org/10.1007/s00132-003-0603-2

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