Hazra Druti, Shaji V Rosemary, Dhall Arushi, Rao Arathi P, Bhat Anil K, Chawla Kiran
Department of Microbiology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Karnataka, India.
Department of Radio Diagnosis, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Karnataka, India.
J Orthop. 2024 May 3;56:92-97. doi: 10.1016/j.jor.2024.05.001. eCollection 2024 Oct.
The delayed identification and management of musculoskeletal tuberculosis (MSTB) poses substantial health challenges and leads to significant morbidity. This study aimed to collate ten years of hospital data and provide valuable insights into the clinical, diagnostics, and outcomes of the patients diagnosed with MSTB.
A retrospective study was undertaken to review clinic records from 2013 to 2022 for all individuals diagnosed with MSTB in a tertiary care hospital in South India.
Over a decade, 400 cases of MSTB were diagnosed, revealing 57 % males and 43 % females with a mean age of 43.2 ± 18.9 years. Spinal TB constituted 72 % of cases, with the most common involvement of thoracic vertebrae (50.9 %). Extra-spinal MSTB accounted for 28 %, prevalent more in the pediatric age group (p < 0.05). Surgical intervention was required for 80 % of spinal TB cases and 58 % of extra-spinal MSTB cases. The average follow-up duration was two years, with 73 % completing treatment. Unfortunately, seven patients died, and three experienced relapse.
Spinal TB is the most common type of MSTB and is predominant in young and middle-aged adults, while extra-spinal MSTB is more frequently observed in children. Where use of MRI facilitates early detection of spinal TB; histopathological and microbiological examination confirm the diagnosis. Combining anti-tubercular drugs with modern surgical approaches is essential for obtaining favorable outcomes and improving the quality of life of such patients. It is crucial to have advanced and affordable diagnostic facilities, along with increased public awareness, to reinforce tuberculosis control strategies.
肌肉骨骼结核（MSTB）的延迟诊断和治疗给健康带来了巨大挑战，并导致了严重的发病率。本研究旨在整理十年的医院数据，为诊断为MSTB的患者的临床、诊断和治疗结果提供有价值的见解。
进行了一项回顾性研究，以审查2013年至2022年期间印度南部一家三级护理医院所有诊断为MSTB的患者的临床记录。
在十年间，共诊断出400例MSTB病例，其中男性占57%，女性占43%，平均年龄为43.2±18.9岁。脊柱结核占病例的72%，最常见于胸椎（50.9%）。脊柱外MSTB占28%，在儿童年龄组中更为普遍（p<0.05）。80%的脊柱结核病例和58%的脊柱外MSTB病例需要手术干预。平均随访时间为两年，73%的患者完成了治疗。不幸的是，7名患者死亡，3名患者复发。
脊柱结核是MSTB最常见的类型，在中青年中占主导地位，而脊柱外MSTB在儿童中更常见。MRI有助于早期发现脊柱结核；组织病理学和微生物学检查可确诊。抗结核药物与现代手术方法相结合对于取得良好治疗效果和改善此类患者的生活质量至关重要。拥有先进且价格合理的诊断设施以及提高公众意识对于加强结核病控制策略至关重要。
