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目的评价椎间盘炎的抗生素预防与介入治疗效果并探讨其影像学表现。材料与方法对２４只新西兰兔采用直视下向椎间盘内注入细菌的方法，制作椎间盘炎动物模型，并随机分为非治疗组、抗生素预防组、抗生素治疗组、介入治疗组。抗生素预防组在椎间盘炎发生前静脉滴注克林霉素３天；抗生素治疗组在椎间盘炎发生１周后静脉给药４周；介入治疗组在椎间盘炎发生１周后用经皮椎间盘切除术（ＰＬＤ）的方法切除部分间盘组织，同时静脉给药１周。实验动物在间盘组织注入细菌后２周与４周，分别行常规Ｘ线，ＣＴ及ＭＲＩ检查。６周后处死动物，实验区脊柱标本送病理学检查，并作细菌培养。结果非治疗组与抗生素治疗组，实验区椎间隙变窄，椎体骨质破坏及增生，尸解显示间盘组织靡烂，椎体边缘骨质破坏；细菌培养多为阳性。介入治疗组，影像学表现为椎间隙变窄，病理检查显示髓核组织被纤维组织取代，细菌培养阴性。抗生素预防组，无椎间盘炎发生。结论ＭＲＩ是发现椎间盘炎的较敏感方法；抗生素预防用药是防止椎间盘炎发生的关键措施；椎间盘炎发生后，单纯静脉给予抗生素不能阻止其病理进程，而介入治疗可有效阻止椎间盘炎的病理进程。
Objective To evaluate the antibiotic prophylaxis and interventional treatment of discitis and to explore its imaging findings. Materials and Methods 24 New Zealand rabbits were randomly divided into non-treatment group, antibiotic prevention group, antibiotic treatment group and interventional treatment group by injecting bacteria into the intervertebral disc under direct vision. In the antibiotic prophylaxis group, clindamycin was intravenously dripped for 3 days before the onset of discitis; in the antibiotic group, iv administration was given for 4 weeks after discitis occurred 1 week later; in the intervention group 1 week after the discitis was treated with percutaneous discectomy (PLD) method to remove part of the disc tissue, while intravenous administration for 1 week. Experimental animals in the intervertebral disc tissue into the bacteria 2 weeks and 4 weeks, respectively, routine X-ray, CT and MRI examination. Six weeks after the animals were sacrificed, the spine specimens were sent for pathological examination and bacterial culture. Results In the non-treatment group and the antibiotic treatment group, the intervertebral space was narrowed in the experimental area, the destruction of the vertebral body and hyperplasia of the vertebral body, the autopsy showed that the intervertebral disc tissue was rotten, and the edge of the vertebral body was destroyed. Most of the bacterial cultures were positive. Interventional therapy group, imaging showed narrowing of intervertebral space, pathological examination showed that the nucleus pulposus was replaced by fibrous tissue, bacterial culture negative. Antibiotic prevention group, no discitis occurred. Conclusions MRI is a more sensitive method to detect discitis. Antibiotic prophylaxis is the key measure to prevent the occurrence of discitis. After the occurrence of discitis, intravenous administration of antibiotics can not prevent the pathological process, and intervention therapy can effectively prevent the pathological process of discitis.