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Rehabilitation Practice and Science

Translated Title

椎間盤感染引起背痛：個案報告

Abstract

Infective discitis accompanying low back pain is uncommon. In general, risk factors for infective discitis include an age greater than 50 years, a history of cancer, unexplained weight loss, pain that lasts more than 1 month, a history of intravenous drug abuse, presence of a urinary tract infection or other infections, diabetes mellitus, and recent invasive procedures. The presence of an elevated erythrocyte sedimentation rate (ESR) and a C-reactive protein (CRP) level have proven to be reliable laboratory criteria consistent with infective discitis. Moreover, magnetic resonance (MR) imaging findings have been shown to have a good sensitivity for infective discitis. Antibiotics are considered the first line of treatment; however, if conservative treatment fails, surgery remains an option.We present herein a 66-year-old male patient who had low back pain with bilateral sciatica for 3 years. A lumbar spine MR image showed L4/L5 spinal stenosis. The patient underwent a L4/L5 laminectomy and a L4/L5 discectomy, then debridement for a wound infection. Progressive low back pain persisted in spite of a clean wound. Laboratory data showed a high CRP and ESR and repeat lumber spine MR imaging revealed L4/L5 infective discitis. Further treatment included a L3-L5 laminectomy, with internal fixation and administration of antibiotics. Postoperatively, the patient could walk independently for short distances with a slow gait.

Language

Traditional Chinese

First Page

57

Last Page

62

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