Khorvash F, Javadi A A, Izadi M, Jonaidi Jafari N, Ranjbar R
Department of Infectious Diseases, Isfahan University of Medical Science, Iran.
Pak J Biol Sci. 2007 Oct 1;10(19):3400-4. doi: 10.3923/pjbs.2007.3400.3404.
The purpose of this study is to review of spinal tuberculosis in three hospitals in Isfahan of Iran. We carried out a cross sectional study of 630 patients with tuberculosis and identified 100 patients with spinal involvement in the three hospitals. Tuberculosis was diagnosed based on one of a compatible clinical picture. A radiographic study of the spine with suspicious signs and skin tested were performed for each patient. Demographic data, sign, symptoms and site of spinal involvement were recorded. In all patients, a chest X ray and sputum smear and culture was performed for rouling out of pulmonary tuberculosis. Out of the 100 patients with spinal tuberculosis, 58% were male and 42% were female. Main symptoms were spinal deformity, local tenderness and neurologic deficits. Fever and constitutional symptoms were in 80% of cases. Only 68% had a positive tuberculin skin test. Three percent involvement were the upper thoracic spine, 23% the lower thoracic spine, 69% also the lower thoracic, T12 and upper lumbar spines, (thoracolumbar) and 5% the cervical spine. 40 cases underwent bone biopsy that 25% had a positive smear, whereas 62.5% had a positive culture. Histologic findings suggestive of tuberculosis involvement of the bone were found in 37 of the 40 biopsies. The most common age for spinal involvement were 20-40 years (p < 0.05). Spinal tuberculosis may be missed in patients with no evidence of pulmonary. No pathognomonic imaging signs allow tuberculosis to be readily distinguished from other conditions. In this here, we discuss about clinical and histopathological findings in patients with spinal tuberculosis.
本研究旨在回顾伊朗伊斯法罕三家医院的脊柱结核情况。我们对630例结核病患者进行了横断面研究，确定了这三家医院中有100例脊柱受累患者。根据相符的临床表现之一诊断结核病。对每位患者进行了脊柱可疑体征的影像学检查和皮肤试验。记录人口统计学数据、体征、症状和脊柱受累部位。对所有患者进行胸部X光、痰涂片和培养以排除肺结核。在100例脊柱结核患者中，58%为男性，42%为女性。主要症状为脊柱畸形、局部压痛和神经功能缺损。80%的病例有发热和全身症状。只有68%的结核菌素皮肤试验呈阳性。3%的受累部位为上胸椎，23%为下胸椎，69%还包括下胸椎、T12和上腰椎（胸腰段），5%为颈椎。40例患者接受了骨活检，其中25%涂片阳性，而62.5%培养阳性。40例活检中有37例发现提示骨结核受累的组织学表现。脊柱受累最常见的年龄为20至40岁（p<0.05）。无肺部证据的患者可能漏诊脊柱结核。没有特征性的影像学征象能使结核病容易地与其他疾病区分开来。在此，我们讨论脊柱结核患者的临床和组织病理学表现。
