Mulleman Denis, Mammou Saloua, Griffoul Isabelle, Avimadje Agbessi, Goupille Philippe, Valat Jean-Pierre
Rheumatology Department, Trousseau Teaching Hospital and School of Medicine, François Rabelais University, 37044 Tours cedex 9, France.
Joint Bone Spine. 2006 Jul;73(4):424-7. doi: 10.1016/j.jbspin.2005.10.013. Epub 2005 Dec 1.
To investigate the characteristics of patients managed for spinal tuberculosis at the rheumatology department of the Tours Teaching Hospital, France, between 1986 and 2003.
Retrospective chart review. The incidence, epidemiology, clinical features, imaging study findings, and diagnostic procedures were recorded.
The annual incidence of spinal tuberculosis was stable throughout the study period. There were 24 patients, 15 women and nine men with a mean age of 61 years; 15 patients were of French descent, three were of Portuguese descent, two were Asian, and four were North-African. Risk factors consisted of alcohol abuse in one patient, diabetes in two patients, glucocorticoid therapy in two patients, and a history of tuberculosis in six patients; none of the patients had AIDS. The cervical spine was involved in two patients, the thoracic spine in 11 patients, and the lumbar spine in 12 patients. Mean time from symptom onset to diagnosis was 4.3 months (range, 1-12 months). Percutaneous vertebral biopsy established the diagnosis in 16 of the 20 patients who underwent this procedure.
The annual incidence of spinal tuberculosis remained unchanged throughout the study period and was not influenced by immigration or the AIDS epidemic. The typical patient was an elderly Caucasian woman of French descent. Reactivation of untreated or inadequately treated tuberculosis was probably the main mechanism.
调查1986年至2003年间法国图尔教学医院风湿科收治的脊柱结核患者的特征。
回顾性病历审查。记录发病率、流行病学、临床特征、影像学检查结果和诊断程序。
在整个研究期间，脊柱结核的年发病率保持稳定。共有24例患者，其中15例女性，9例男性，平均年龄61岁；15例为法国血统，3例为葡萄牙血统，2例为亚洲人，4例为北非裔。危险因素包括1例酒精滥用患者、2例糖尿病患者、2例糖皮质激素治疗患者和6例有结核病史患者；所有患者均无艾滋病。2例患者颈椎受累，11例患者胸椎受累，12例患者腰椎受累。从症状出现到诊断的平均时间为4.3个月（范围1 - 12个月）。在接受经皮椎体活检的20例患者中，16例通过该检查确诊。
在整个研究期间，脊柱结核的年发病率保持不变，不受移民或艾滋病流行的影响。典型患者为法国血统的老年白种女性。未治疗或治疗不充分的结核复发可能是主要机制。
