头孢唑啉预防治疗羊椎间盘感染解析.pdf

Eur Spine J (2006) 15:1397–1403 DOI 10.1007/s00586-006-0144-6 ORIGINAL ARTICLE Preventing and treating discitis: cephazolin penetration in ovine lumbar intervertebral disc Rebecca Walters Æ Razmi Rahmat Æ Robert Fraser Æ Robert Moore Received: 4 August 2005 / Revised: 22 January 2006 / Accepted: 27 April 2006 / Published online: 8 July 2006 Springer-Verlag 2006 Abstract Infection can occur after any spinal proce- dose of prophylactic cephazolin before inoculation dure that violates the disc and although it is not com- while the remaining sheep (‘‘treatment’’ group) were mon, the potential consequences are serious. treated with cephazolin commencing 7 days after Treatment of discitis is not always successful and the inoculation for 21 days at a dose of 50 mg/kg/day. key to management is prevention. Intradiscal prophy- Histopathology and radiography were used to assess laxis with antibiotic is routinely used in spinal surgery, the effect of the different treatments. Cephazolin was but there is a limited understanding of how well anti- given 30 min prior to sacrifice and the intradiscal biotics can enter the avascular disc after intravenous concentration was measured by biochemistry. In the injection. An in vivo ovine study to optimise prophy- ‘‘prophylaxis’’ group all doses of antibiotic provided lactic and parenteral treatment of discitis is described some protection against infection, although it was not to assess the effectiveness of cephazolin in preventing dose dependent. In the ‘‘treatment’’ group discitis was and treating infection. The concentration of cephazolin confirmed radiologically and histologically in all ani- was measured in disc tissue from normal an