Quarta L, Corrado A, Melillo N, Trotta A, Scotto G, d'Onofrio F, Santoro N, Cantatore F P
Department of Rheumatology, University of Foggia Medical School, Foggia, Italy.
Rheumatol Int. 2008 Mar;28(5):495-8. doi: 10.1007/s00296-007-0460-0. Epub 2007 Sep 26.
Because of the increased incidence of tuberculosis (TB) in recent years, infective spondylitis is still a major problem in the world. In skeletal TB the spine is the most often involved and lumbosacral spine involvement is rare. Nowadays early diagnosis and new medical treatment can reduce the incidence of the serious skeletal sequelae and the number of surgery procedures in spinal TB. We present a case of TB spondylodiscitis characterized by a rapid and progressive clinical and radiological improvement after treatment with Neridronate and chemotherapic drugs. Our data suggest that in the treatment of the TB spondylodiscitis the combined use of these drugs is a good alternative to stimulate bone reparative process to the chemotherapy alone. To our knowledge this is first case of a patient with TB discitis treated with Neridronate. Further studies are necessary to confirm the effectiveness of Neridronate treatment added to antiTB drugs in spondylodiscitis.
由于近年来结核病(TB)发病率上升,感染性脊柱炎仍是全球的一个主要问题。在骨结核中,脊柱是最常受累的部位,而腰骶椎受累罕见。如今,早期诊断和新的药物治疗可降低脊柱结核严重骨骼后遗症的发生率和手术次数。我们报告一例结核性脊椎椎间盘炎病例,该病例在接受奈立膦酸和化疗药物治疗后,临床和影像学表现迅速且持续改善。我们的数据表明,在结核性脊椎椎间盘炎的治疗中,联合使用这些药物是刺激骨修复过程的良好选择,优于单纯化疗。据我们所知,这是首例使用奈立膦酸治疗结核性椎间盘炎的患者。需要进一步研究以证实奈立膦酸联合抗结核药物治疗脊椎椎间盘炎的有效性。