Ogle J W, Wilson F C, McConnachie C C
Division of Orthopaedics, University of North Carolina School of Medicine, Chapel Hill.
S Afr Med J. 1994 Sep;84(9):614-8.
To understand better the prevalence, distribution and major causes of sagittal spinal deformity in a rural homeland, the authors conducted a study of angular kyphosis in the spines of 2,329 Transkei patients. Thirty-one (1.33%) had angular kyphosis. Lateral chest radiographs were obtained from 22 of these patients. Radiographic kyphotic angles ranged from 28 degrees to 130 degrees (mean: 70.3 +/- 7.6). The vast majority (81%) demonstrated classical clinical and/or radiographic findings of tuberculous aetiology. Less frequent aetiologies included fractures (2), osteoporosis (1), congenital malformation (1) and kyphosis of unknown origin (2). Eleven of the kyphotic patients were seeking care for unrelated problems and were asymptomatic in respect of their kyphoses. As a subset, the asymptomatic individuals demonstrated a similar aetiological distribution, with 73% strongly suggestive of tuberculous aetiology. The prevalence of asymptomatic angular kyphosis in this unselected Transkei patient population was 0.47% +/- 0.14%. In this hospital-based study, angular kyphosis proved a valuable marker for spinal tuberculosis. Because tuberculous spondylitis is more successfully treated when detected early, spinal palpation should be included in the routine physical examination of patients or populations at risk for tuberculosis.
为了更深入了解一个乡村地区矢状面脊柱畸形的患病率、分布情况及主要病因，作者对2329名特兰斯凯患者的脊柱角状后凸进行了研究。其中31人（1.33%）存在角状后凸。对其中22名患者进行了胸部侧位X线检查。X线后凸角度范围为28度至130度（平均：70.3±7.6）。绝大多数（81%）表现出结核病因的典型临床和/或X线表现。其他较少见的病因包括骨折（2例）、骨质疏松（1例）、先天性畸形（1例）及不明原因的后凸（2例）。11名后凸患者因其他无关问题就医，其脊柱后凸无症状。作为一个亚组，无症状个体的病因分布相似，73%强烈提示结核病因。在这个未经筛选的特兰斯凯患者群体中，无症状角状后凸的患病率为0.47%±0.14%。在这项基于医院的研究中，角状后凸被证明是脊柱结核的一个有价值的指标。由于结核性脊柱炎早期发现时治疗更成功，因此在对有结核病风险的患者或人群进行常规体格检查时应包括脊柱触诊。
