EROSIVE INTERVERTEBRAL OSTEOCHONDROSIS - DIAGNOSTIC AND THERAPY

Pathogenically the erosive intervertebral osteochondrosis is the destr uctive form of the intervertebral osteochondrosis. This paper aims to define this acute variant by means of diagnostic criteria. In differen tial diagnosis a spondylodiscitis, an ankylosing spondylitis, a destru ctive spondylathropathy and a morbus Scheuermann must be considered. F ifteen patients with erosive osteochondrosis were treated at the Depar tment of Orthopaedic Surgery of the University of Mainz between 1990 a nd 1994. The diagnosis on admission into hospital was incorrect in all cases. Plain X-rays showed a decrease in height in the affected inter vertebral room and bony erosions of the adjacent vertebral endplates. Distinction to spondylodiscitis was possible in MRT. In contrast to er osive osteochondrosis in spondylodiscitis edema cannot only be seen in the adjoinig vertebrae but also in the affected disc. In later parave rtebral inflammatory abscess often can be found. After conservative tr eatment four patients were free of complaints. 11 Patients were operat ed on due to neurologic symptoms or increasing kyphosis of the lumbar spine. At average follow-up of 16 months intervertebral fusion was fou nd in all operated patients. Lack of publicity and severance to spondy lodiscitis seem to be major problems in diagnosing erosive osteochondr osis.