Tuli S M
Department of Orthopaedics and Rehabilitation, Delhi University College of Medical Sciences, India.
Int Orthop. 1995;19(5):327-31. doi: 10.1007/BF00181121.
Almost 3% of cases of tuberculosis of the spine develop a severe kyphotic deformity. The patients at risk are those who developed the disease under the age of 10 years, who had involvement of three or more vertebral bodies and had lesions between C7 to L1. A severe kyphosis is more than a cosmetic disfigurement because nearly all such patients develop cardiopulmonary dysfunction, painful impingement between ribs and pelvis and compression of the spinal cord with paraplegia at an average of 10 years after the onset of the disease. Correction of the established deformity is difficult and dangerous. Anterior transposition of the cord does not always result in permanent neurological recovery, so it is imperative to diagnose and treat the condition either before bony destruction has occurred or when it is in an early phase. Those patients who are at risk of developing a severe deformity should be treated by posterior fusion of the spine.
近3%的脊柱结核病例会发展为严重的脊柱后凸畸形。有风险的患者是那些在10岁以下患病、累及三个或更多椎体且病变位于C7至L1之间的患者。严重脊柱后凸不仅仅是外观畸形，因为几乎所有此类患者在疾病发作后平均10年会出现心肺功能障碍、肋骨与骨盆之间的疼痛性撞击以及脊髓受压伴截瘫。矫正已形成的畸形既困难又危险。脊髓前移并不总能带来永久性神经功能恢复，因此在骨质破坏发生之前或处于早期阶段时诊断和治疗该病症至关重要。那些有发展为严重畸形风险的患者应接受脊柱后路融合术治疗。
