| Objective:Postoperative discitis is a serious complication of the spinal surgery and interventional therapy . The early sign of the postoperative discitis is obscure and the treatment of the disease is difficult . The objective of the study was that searching the prevention and treatment as well as medical imaging performance of the disease for lowing the incidence of the disease and that getting enough knowledge of the medical imaging performance of the disease for proper diagnosing the disease , and that providing effective preventive and treatmental measures as well as the theoretical base for the diseaseMaterial and methods:1.To establish the determined method of the antibiotics permeability into intervertebral disc:five antibiotics, Cephazolin, Flucloxacillin, Clindamycin, Tobramycin and Penicillin G, were administrated introvenously respectively to studying objectives. The concentration of the antibiotics in the nucleus pulposus and serum were determined and analyzed by high performance liquid chromatography method.2.To establish the animal discitis model:Demonstrated the lower lumbar disc of the rabbits with retroperitoneol approach , injecting the staphylococcus aureus into discs directly for inducing to occur the discitis.3.The experimental effect observation of the prevention and treatment of the discitis: The rabbits6made discitis models were classified 4 groups randomly Non-treatment group , Prophylactic antibiotics group, Therapeutic antibiotics group, Interventional group. In the non-treatment group, no treatment measure was taken. In the prophyclatic antibiotics group, the rabbits were administered intravenously clindamycin before 3 days the inoculation of bacteria to disc. In therapeutic antibiotics group , 4-week course of intravenous antibiotics was commenced 1 week after the bacterial inoculation. In the interventional treatment group the rabbits were performed with PLD. 1 week after the inoculation, simultaneous intravenous antibiotics were given for a period of 1 week.4.Medical imaging examination: 2 and 4 weeks after inoculation, all rabbits' lumbar spins were examined by X-rays, CT, MRI respectively. CT scan was performed with slice thick 2mm, MRJ was performed (l.OT superconducting system, spine surface coil, spin echo sequence) at the regions of the experimental spine with sagittal and coronal scan.5.The experimental sample management: After 6 weeks of injecting the staphylococcus aureus inoculation to discs, all rabbits were killed, the whole thoracic and lumbar spines were taken, needle biopsies of nuclear pulpous were obtain from experiment regions of lumbar spine were removed for pathological examination. Spine samples were cut with sagittaly and coronaly, and fixed with formalin , recovered color with pure alcohol , to observe the correlative change between pathology and medical imaging.6.Clinical study:35 cases with discitis with confirmed by clinical data and medical imaging examination were administrated with antibiotics 3 days , then performed percutaneous lumbar discectomy(PLD) for removing infectious disc tissue, and douched with antibiotics in local areas. The removing disc tissues were examined by pathology.7Results:1.The antibiotics permeability into intervertebral disc: Clindamycin and Tobramycin have higher permeability into intervertebral disc , Cephazolin could also infiltrate into intervertebral disc. The concentration of them could reach and exceed MIC in intervertebral disc. Flucloxacillin and Penicillin G have lower permeability into intervertebral disc , The concentration of them couldn' t reach MIC in intervertebral disc.2.The experimental effect of the prevention and treatment of the discitis: In the non-treatment group and the therapeutic antibiotics group , the experimental discs inoculated with bacteria developed active discitis; In interventional treatment group, the experimental discs inoculated with bacteria have only intervertebral space narrow without active discitis performance. In prophylactic antibioti...
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