[1]李松 张聃 罗满 刘骏鹏 王韬 史明.腰椎化脓性感染的研究进展[J].中国中医骨伤科杂志,2026,34(05):107-112.[doi:10.20085/j.cnki.issn1005-0205.260516]
　LI Song,ZHANG Dan,LUO Man,et al.Research Progress on Pyogenic Infection of the Lumbar Spine[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2026,34(05):107-112.[doi:10.20085/j.cnki.issn1005-0205.260516]
点击复制

腰椎化脓性感染的研究进展()

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第34卷
期数:
2026年05期
页码:
107-112
栏目:
文献综述
出版日期:
2026-05-10

文章信息/Info

Title:
Research Progress on Pyogenic Infection of the Lumbar Spine
文章编号:
1005-0205(2026)05-0107-06
作者:
李松 张聃 罗满 刘骏鹏 王韬 史明
1广西中医药大学附属国际壮医医院(南宁,530200)
2广西中医药大学
Author(s):
LI Song1; 2; ZHANG Dan1; LUO Man1; LIU Junpeng2; WANG Tao2; SHI Ming1△
1International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine,Nanning 530200,China; 2Guangxi University of Chinese Medicine,Nanning 530200,China.
关键词:
腰椎化脓性感染;  流行病学;  病因;  诊断;  治疗;  综述
Keywords:
pyogenic infection of the lumbar spine;  epidemiology;  etiology;  diagnosis;  treatment;  summary
分类号:
R681.2
DOI:
10.20085/j.cnki.issn1005-0205.260516
文献标志码:
A
摘要:
脊柱化脓性感染是脊柱外科领域的重要临床问题,腰椎是此类感染最常累及的部位,这与该节段机械负荷高、活动度大、血供丰富及退行性病变高发等因素密切相关,虽总体发病率不高,但腰椎化脓性感染可导致严重的神经功能损害、脊柱结构失稳及长期功能障碍,故而整合其诊治过程具有显著的临床意义。系统综述了该疾病在流行病学特征、病理生理机制、临床表现、诊断方法、治疗干预及预后评估等方面的研究进展。
Abstract:
Pyogenic spinal infections represent a significant clinical challenge in the field of spinal surgery,with the lumbar spine being the most frequently affected site.This predilection is closely associated with factors such as high mechanical stress,a substantial range of motion,a rich blood supply,and a high incidence of degenerative changes in this region.Although the overall incidence is relatively low,lumbar suppurative spinal infections(LSSI)can lead to severe neurological impairment,spinal instability,and long-term functional disabilities,underscoring the considerable clinical importance of their diagnosis and management.This article provides a systematic review of the recent advances in the epidemiological characteristics,pathophysiological mechanisms,clinical manifestations,diagnostic approaches,therapeutic interventions,and prognostic assessments of this condition.

参考文献/References:

[1] GUO W,WANG M,CHEN G F,et al.Early surgery with antibiotic medication was effective and efficient in treating pyogenic spondylodiscitis[J].BMC Musculoskeletal Disorders,2021,22(1):288.
[2] GIORGI H,BLONDEL B,ADETCHESSI T,et al.Early percutaneous fixation of spinal thoracolumbar fractures in polytrauma patients[J].Orthopaedics & Traumatology:Surgery & Research,2014,100(5):449-454.
[3] 欧肇兰,罗春晓,张慧玲,等.脊柱外科感染临床流行病学及影响因素[J].中华医院感染学杂志,2020,30(19):3000-3004.
[4] URRUTIA J,BONO C M.Update on the diagnosis and management of spinal infections[J].Instructional Course Lectures,2022,71:439-449.
[5] SALEH E S,VASILEFF C C,OMARI A M,et al.The diagnosis and management of pediatric spine infections[J].Cureus,2021,13(7):e16748.
[6] 李志兵.内镜下病灶清除万古霉素硫酸钙置入治疗腰椎化脓性感染的疗效研究[D].南宁:广西中医药大学,2025.
[7] LENER S,HARTMANN S,BARBAGALLO G M V,et al.Management of spinal infection:a review of the literature[J].Acta Neurochirurgica,2018,160(3):487-496.
[8] SATO K,YAMADA K,YOKOSUKA K,et al.Pyogenic spondylitis:clinical features,diagnosis and treatment[J].The Kurume Medical Journal,2019,65(3):83-89.
[9] KIM N J.Microbiologic diagnosis of pyogenic spondylitis[J].Infection & Chemotherapy,2021,53(2):238-246.
[10] ZIARKO T P,WALTER N,SCHINDLER M,et al.Risk factors for the in-hospital mortality in pyogenic vertebral osteomyelitis:a cross-sectional study on 9 753 patients[J].Journal of Clinical Medicine,2023,12(14):4805.
[11] BALCESCU C,ODEH K,ROSINSKI A,et al.Pyogenic spinal infections warrant a total spine MRI[J].Journal of Bone and Joint Infection,2023,8(1):1-9.
[12] TSANTES A G,PAPADOPOULOS D V,VRIONI G,et al.Spinal infections:an update[J].Microorganisms,2020,8(4):476.
[13] ALJAWADI A,JAHANGIR N,JEELANI A,et al.Management of pyogenic spinal infection,review of literature[J].Journal of Orthopaedics,2019,16(6):508-512.
[14] KOLAKOWSKA A,EL ALAOUI F,BEN ALBA H,et al.Vaginal microbiota as an unusual cause of spondylodiscitis[J].Archives of Gynecology and Obstetrics,2022,306(1):109-114.
[15] 朱乘春,冯大雄,杨启远,等.老年腰椎骨折术后深部切口感染病原菌耐药性及危险因素分析[J].中国病原生物学杂志,2025,20(1):90-94.
[16] 王仕永,姚汝斌,任莉荣,等.腰椎融合术后切口深部感染的危险因素分析[J].中国脊柱脊髓杂志,2020,30(10):872-879.
[17] KRAMER A,THAVARAJASINGAM S G,NEUHOFF J,et al.Diagnosis and management of de novo non-specific spinal infections:European Association of Neurosurgical Societies(EANS)Spine Section Delphi consensus recommendations[J].Brain and Spine,2025,5:104178.
[18] YOO L J H,ZULKIFLI M D,O'CONNOR M,et al.Parvimonas micra spondylodiscitis with psoas abscess[J].BMJ Case Reports,2019,12(11):e232040.
[19] 于海宽,张成程,刘耀升.厌氧菌感染性脊柱炎诊断与治疗研究进展[J].中华骨与关节外科杂志,2025,18(8):758-764.
[20] JEAN M,IRISSON J O,GRAS G,et al.Diagnostic delay of pyogenic vertebral osteomyelitis and its associated factors[J].Scandinavian Journal of Rheumatology,2017,46(1):64-68.
[21] BAE J Y,KIM C J,KIM U J,et al.Concordance of results of blood and tissue cultures from patients with pyogenic spondylitis:a retrospective cohort study[J].Clinical Microbiology and Infection,2018,24(3):279-282.
[22] MA C Y,WU H B,CHEN G,et al.The potential of metagenomic next-generation sequencing in diagnosis of spinal infection:a retrospective study[J].European Spine Journal,2022,31(2):442-447.
[23] LIU X Y,ZHENG M M,JIANG Z S,et al.Computed tomography imaging characteristics help to differentiate pyogenic spondylitis from brucellar spondylitis[J].European Spine Journal,2020,29(7):1490-1498.
[24] SHROYER S,BOYS G,APRIL M D,et al.Imaging characteristics and CT sensitivity for pyogenic spinal infections[J].The American Journal of Emergency Medicine,2022,58:148-153.
[25] COSCIA M F,DENYS G A,WACK M F.Propionibacterium acnes,coagulase-negative staphylococcus,and the “biofilm-like” intervertebral disc[J].Spine,2016,41(24):1860-1865.
[26] ROTZINGER R,OMIDI R,GEBHARD H,et al.Spondylodiscitis and epidural abscesses[J].Der Radiologe,2021,61(3):275-282.
[27] DHODAPKAR M M,PATEL T,RUBIO D R.Imaging in spinal infections:current status and future directions[J].North American Spine Society Journal,2023,16:100275.
[28] RICHARDS T,STEPHEN J,LUI C L.Severe disseminated Veillonella parvula infection including endocarditis,bilateral psoas abscess,discitis,and osteomyelitis but sparing spinal and hip prostheses:a case report[J].Journal of Medical Case Reports,2022,16(1):157.
[29] MAAMARI J,GRACH S L,PASSERINI M,et al.The use of MRI,PET/CT,and nuclear scintigraphy in the imaging of pyogenic native vertebral osteomyelitis:a systematic review and meta-analysis[J].The Spine Journal,2023,23(6):868-876.
[30] KLOIBER R,LAFFORD H,KOSLOWSKY I L,et al.A practical approach to interpretation of 18F-fluorodeoxyglucose positron emission tomography/computed tomography for postoperative spine infection[J].Skeletal Radiology,2024,53(4):741-752.
[31] STANGENBERG M,MENDE K C,MOHME M,et al.Influence of microbiological diagnosis on the clinical course of spondylodiscitis[J].Infection,2021,49(5):1017-1027.
[32] KEIL C F,FINGER S B,LAASCH N,et al.Vanishing vacuum disc phenomenon:a diagnostic key in spinal infection[J].European Spine Journal,2025,34(10):4650-4660.
[33] BERNARD L,DINH A,GHOUT I,et al.Antibiotic treatment for 6 weeks versus 12 weeks in patients with pyogenic vertebral osteomyelitis:an open-label,non-inferiority,randomised,controlled trial[J].The Lancet,2015,385(9971):875-882.
[34] KÖRPNAR �瘙 塁 .Could hyperbaric oxygen be a solution in the treatment of spinal infections?[J].Medicina,2019,55(5):164.
[35] HADJIPAVLOU A G,MADER J T,NECESSARY J T,et al.Hematogenous pyogenic spinal infections and their surgical management[J].Spine,2000,25(13):1668-1679.
[36] THAVARAJASINGAM S G,VEMULAPALLI K V,VISHNU K S,et al.Conservative versus early surgical treatment in the management of pyogenic spondylodiscitis:a systematic review and meta-analysis[J].Scientific Reports,2023,13:15647.
[37] BEHMANESH B,GESSLER F,DUETZMANN S,et al.Quality of life following surgical and conservative therapy of pyogenic spinal infection:a study of long-term outcome in 210 patients[J].Journal of Neurological Surgery,Part A:Central European Neurosurgery,2023,84(1):14-20.
[38] 朱庭标,张勇,赵爱彬,等.VSD技术在脊柱内固定术后早期深部感染治疗中的应用[J].中国骨与关节损伤杂志,2016,31(5):530-531.
[39] 邢皓,常正奇,林琳.封闭负压引流与普通负压引流治疗胸腰椎感染对比研究[J].潍坊医学院学报,2024,46(1):44-47.
[40] NOVAK I,KOAK R,TRAVNIK L,et al.Polyetheretherketone(PEEK)cages for anterior column reconstruction in pyogenic vertebral osteomyelitis[J].Journal of Orthopaedic Surgery,2019,27(2):2309499019842490.
[41] YAW TEE L Y,HUNTER S,BAKER J F.BMP use in the surgical treatment of pyogenic spondylodiscitis:is it safe?[J].Journal of Clinical Neuroscience,2022,95:94-98.
[42] LILJENQVIST U,LERNER T,BULLMANN V,et al.Titanium cages in the surgical treatment of severe vertebral osteomyelitis[J].European Spine Journal,2003,12(6):606-612.
[43] 于达.钛表面金属酚醛网络接枝抗菌肽涂层的抗菌性能及生物相容性研究[D].合肥:安徽医科大学,2024.
[44] MUTOH M,FUKUOKA T,SUZUKI O,et al.Three-staged surgical strategy as a combined approach for multilevel cervical pyogenic spondylodiscitis[J].Cureus,2021,13(9):e17747.
[45] 张俊辉,陈锦旭,梁卓贤,等.全可视椎间孔镜治疗腰椎椎间隙感染:脊柱稳定性的有限元分析[J].中国组织工程研究,2026,30(15):3801-3809.
[46] 李世文,侯宝煜,丁汉忠,等.内镜清创持续灌洗引流治疗胸腰椎化脓性感染[J].中国矫形外科杂志,2025,33(2):168-171.
[47] 李生鋆,李俊,张晓锐,等.斜外侧椎间融合术通道技术在腰椎感染中的应用[J].中国骨伤,2025,38(5):473-481.
[48] YAMADA K,TAKAHATA M,NAGAHAMA K,et al.Posterolateral full-endoscopic debridement and irrigation is effective in treating thoraco-lumbar pyogenic spondylodiscitis,except in cases with large abscess cavities[J].European Spine Journal,2023,32(3):859-866.
[49] BORNEMANN R,RÖSSLER P,JACOBS C,et al.Spondylitis-spondylodiscitis:an update[J].Zeitschrift für Orthopädie und Unfallchirurgie,2019,157(2):132-143.
[50] KINAMON T,DAGHER M,PARK L,et al.Risk factors and outcomes of hematogenous vertebral osteomyelitis in patients with staphylococcus aureus bacteremia[J].Clinical Infectious Diseases,2023,77(9):1226-1233.
[51] KALS K S,RAMAYANI A,HARIHARAN R,et al.A rare multilevel spinal epidural abscess with streptococcus agalactiae in an adult with uncontrolled diabetes:a case report[J].Cureus,2023,15(8):e42802.
[52] SOBOTTKE R,ZARGHOONI K,KRENGEL M,et al.Treatment of spondylodiscitis in human immunodeficiency virus-infected patients:a comparison of conservative and operative therapy[J].Spine,2009,34(13):E452-E458.
[53] 李鑫,张强,赵昌松,等.HIV感染者与无HIV感染者脊柱手术切口愈合情况的对比观察[J].中国脊柱脊髓杂志,2017,27(3):248-253.
(收稿日期:2025-09-30)

备注/Memo

备注/Memo:
基金项目:广西重点研发计划项目(桂科AB25069079)
国家中医优势专科建设项目(桂中医药发〔2025〕 4号)
广西中医药适宜技术开发与推广项目(GZSY2025045)
广西中医药大学2025年研究生教育创新计划项目(YCSY2025089)
△通信作者 E-mail:shiming621@126.com
更新日期/Last Update: 2026-05-15