化膿性脊椎炎に対して持続洗浄ドレナージを行った2例

Treatment of Pyogenic Spondylitis by Closed Irrigation-suction. Report of Two Cases

　保存的治療に抵抗したcompromised hostの化膿性脊椎炎に対して外科的なドレナージを行い奏効した症例を経験した．症例1は86歳の女性で，第1腰椎椎体膿瘍に対して経椎弓根的にドレーンチューブを留置し持続洗浄を行うことで感染を鎮静化することができた．症例2は73歳の女性で，第7胸椎椎体周囲膿瘍に対して保存的治療を行い，治療中に対麻痺を発症したため緊急で膿瘍の掻爬と後方固定術を行い，持続洗浄ドレナージを追加することで感染の鎮静化と麻痺の改善を得ることができた．

　There are more opportunities to treat pyogenic spondylitis have today because of the increase in immunocompromised hosts and elderly people.　The patient in case 1 was an 86-year-old woman with pyogenic spondylitis of the L1 vertebral body.　Three months of conservative treatment were ineffective, and we treated the infection by closed irrigation-suction of the L1 abscess.　The patient in case 2 was a 73-year-old woman with an abscess in a collapsed Th7 vertebral body.　Paralysis was caused by compression by the Th7 abscess.　Emergency posterior fusion and closed irrigation-suction were performed, and the infection and paralysis improved.　Although instrumentation is usually contraindicated in infection, the results suggested that it was valid in these two cases.