Emel Erhan, Güzey Feyza Karagöz, Güzey Deniz, Bas N Serdar, Sel Baris, Alatas Ibrahim
Department of Neurosurgery, SSK Vakif Gureba Training Hospital, Fatma Sultan M Kahal Bagi S 31/6 Fatih, 34096, Istanbul, Turkey.
Eur Spine J. 2006 Jun;15(6):1019-24. doi: 10.1007/s00586-005-0989-0. Epub 2006 Apr 7.
There are only a few cases reported with non-contiguous spinal tuberculosis in the literature. Most of these patients have only two non-contiguous lesions, and in almost all of these cases, surgical treatment is required.
A 17-year-old girl with non-contiguous multifocal spinal tuberculosis involving cervical, thoracic, thoracolumbar, lumbar and sacral segments is reported. The patient presented with systemic tuberculosis symptoms and signs, and progressive paraparesis.
The patient was treated with antituberculous drug therapy and was operated twice for thoracolumbar and cervical spinal lesions. She made an excellent neurological recovery.
In the patients with non-contiguous spinal involvement, there is a high percentage of requirement of surgical treatment. This may be due to "fulminant" behaviour of the disease in these patients. Early surgical treatment of the cases with large abscesses and systemic tuberculosis may provide early improvement, and must probably be the first treatment modality after general support to the patient.
文献中报道的非连续性脊柱结核病例较少。这些患者大多仅有两处非连续性病灶，且几乎所有这些病例都需要手术治疗。
报告一名17岁女孩，患有累及颈椎、胸椎、胸腰段、腰椎和骶椎节段的非连续性多灶性脊柱结核。该患者出现全身结核症状和体征，以及进行性双下肢轻瘫。
患者接受抗结核药物治疗，并因胸腰段和颈椎病变接受了两次手术。她的神经功能恢复良好。
在非连续性脊柱受累的患者中，手术治疗的需求比例很高。这可能是由于该疾病在这些患者中具有“暴发性”表现。对于有大脓肿和全身结核的病例，早期手术治疗可能会带来早期改善，并且很可能是在对患者进行一般支持后的首选治疗方式。
