Buranapanitkit B, Lim A, Kiriratnikom T
Department of Orthopaedic Surgery, Prince of Songkla University, Thailand.
J Med Assoc Thai. 2001 Nov;84(11):1522-6.
The authors compared clinical and baseline parameters between patients with tuberculous spondylitis (67 patients) and pyogenic vertebral osteomyelitis (34 patients). The average age was 50.8 (range, 1 to 82 years). Males were slightly more predominant in both pyogenic and tuberculous infections. Seventy per cent of patients with pyogenic infection had had symptoms for less than 3 months, while this was the case for only 44 per cent of the tuberculous patients. Lumbar spine was the most common site of involvement. Associated infections were more commonly found in tuberculous infection. Thirty per cent of tuberculous spondylitic patients were initially misdiagnosed, while 44 per cent of patients with pyogenic vertebral osteomyelitis had delayed diagnosis. Only 20 per cent and 30 per cent of tuberculous and pyogenic patients had fever, respectively. Neurological deficit occurred more frequently in pyogenic than in tuberculous infection (79% vs 59%), while bowel bladder involvement was more commonly found in tuberculous spondylitis. Kyphosis was significantly more common in tuberculosis than in pyogenic infection (50.8% vs 26.5%, respectively). Sinus tract formation, subcutaneous abscess formation and positive for SLRT (straight-leg-raising test) were found in only a small percentage of the patients. Duration of symptoms, site, associated infection, kyphosis and neurological deficit could be used for differentiation of spinal infection.
作者比较了结核性脊柱炎患者（67例）和化脓性椎体骨髓炎患者（34例）的临床及基线参数。平均年龄为50.8岁（范围1至82岁）。在化脓性和结核性感染中男性均略占多数。70%的化脓性感染患者症状持续时间不到3个月，而结核性患者中这一比例仅为44%。腰椎是最常受累的部位。合并感染在结核性感染中更为常见。30%的结核性脊柱炎患者最初被误诊，而44%的化脓性椎体骨髓炎患者诊断延迟。结核性和化脓性患者发热的比例分别仅为20%和30%。神经功能缺损在化脓性感染中比在结核性感染中更常见（79%对59%），而肠道膀胱受累在结核性脊柱炎中更常见。脊柱后凸在结核中比在化脓性感染中明显更常见（分别为50.8%对26.5%）。只有一小部分患者出现窦道形成、皮下脓肿形成和直腿抬高试验阳性。症状持续时间、部位、合并感染、脊柱后凸和神经功能缺损可用于鉴别脊柱感染。
