Benzagmout Mohammed, Boujraf Saïd, Chakour Khalid, Chaoui Mohammed El Faïz
Department of Neurosurgery, University Hospital Hassan II, Fez- Morocco, Faculty of Medicine and Pharmacy of Fez, Morocco.
Surg Neurol Int. 2011 Jan 11;2:1. doi: 10.4103/2152-7806.75459.
The incidence of tuberculosis is increasing, and skeletal tuberculosis accounts for 10-20% of all extrapulmonary cases. Spinal tuberculosis occurs mostly in children and young adults. It causes bone destruction, spinal deformity and neural complications.
Our study includes 37 children (below 15 years of age) with spinal tuberculosis treated in our department in the last 6 years. The demographic data, clinical profile, surgical intervention and outcome of these children are reported.
The mean age ranged from 4 to 15 years, with an average of 9.1 years, and the male/female ratio was 1.8. Thirty patients (81%) had progressive inflammatory rachialgia and only six patients (16.2%) had neurological symptoms. The lumbar spine was mostly affected (23 cases). All patients have benefited from antituberculous chemotherapy (Regimen 2SRHZ/10RH) associated with spinal immobilization during 3 months. The surgical treatment was indicated in seven patients because of the presence of large bilateral abscess of the psoas muscle in one patient and the presence of severe neurological symptoms in the six remaining patients. The evolution was favorable in all cases, including those with neurological symptoms. There was no case of death and the length of follow-up for these patients ranged between 1 and 4 years.
Spinal tuberculosis is still a prevalent disease in developing countries, mainly occurring in children. Complications of the disease can be devastating because of its ability to cause bone destruction, spinal deformity and paraplegia. Therefore, an early diagnosis and establishment of treatment are necessary to expect a good outcome.
结核病发病率呈上升趋势,骨结核占所有肺外病例的10%-20%。脊柱结核多发生于儿童和青年。它会导致骨质破坏、脊柱畸形和神经并发症。
我们的研究纳入了过去6年在我科接受治疗的37例15岁以下脊柱结核患儿。报告了这些患儿的人口统计学数据、临床特征、手术干预及治疗结果。
平均年龄为4至15岁,平均9.1岁,男女比例为1.8。30例(81%)有进行性炎性脊柱痛,仅6例(16.2%)有神经症状。腰椎受累最为常见(23例)。所有患者均受益于抗结核化疗(2SRHZ/10RH方案),并在3个月内进行脊柱固定。7例患者接受了手术治疗,其中1例因双侧腰大肌巨大脓肿,其余6例因存在严重神经症状。所有病例病情均呈好转趋势,包括有神经症状的病例。无死亡病例,这些患者的随访时间为1至4年。
脊柱结核在发展中国家仍是一种常见疾病,主要发生于儿童。该疾病的并发症可能具有毁灭性,因为它能够导致骨质破坏、脊柱畸形和截瘫。因此,早期诊断并开始治疗对于取得良好预后很有必要。