Pun W K, Chow S P, Luk K D, Cheng C L, Hsu L C, Leong J C
Department of Orthopaedic Surgery, University of Hong Kong, Queen Mary Hospital.
J Bone Joint Surg Br. 1990 Jul;72(4):675-8. doi: 10.1302/0301-620X.72B4.2143192.
Of 37 consecutive patients suffering from tuberculosis of the lumbosacral spine, 26 were reviewed after an average follow-up of 20 years. Those presenting at under 10 years of age usually had a discharging sinus or a pointing abscess and a visible kyphosis. In older patients, low back pain was the predominant presenting symptom. Neurological involvement was uncommon. Both operative and conservative treatment had resulted in fusion but all patients treated conservatively ended up with a kyphosis associated with trunk shortening. They had a higher incidence of back pain and more complications in pregnancy. Anterior debridement and fusion with a strut graft can reduce the incidence and size of kyphosis, but is technically demanding. Treatment remains difficult and requires individual consideration.
在连续37例腰骶部脊柱结核患者中，对26例进行了平均20年的随访复查。10岁以下发病的患者通常有窦道流脓或脓肿形成以及明显的脊柱后凸。年龄较大的患者以腰背痛为主要表现症状。神经受累情况不常见。手术治疗和保守治疗均导致了脊柱融合，但所有接受保守治疗的患者最终都出现了与躯干缩短相关的脊柱后凸。他们背痛的发生率较高，孕期并发症更多。前路清创并使用支撑植骨融合可降低脊柱后凸的发生率和程度，但技术要求较高。治疗仍然困难，需要个体化考虑。
