Hayes A J, Choksey M, Barnes N, Sparrow O C
East London Tuberculosis Centre, Whitechapel, UK.
J R Coll Surg Edinb. 1996 Jun;41(3):192-6.
A review of 21 cases of patients with spinal tuberculosis has been performed, with special attention being paid to methods of diagnosis and the surgical treatment undertaken. We found that the clinical presentation of the condition was often similar to that of malignant disease within the spine, with the commonest presenting features being back pain (95%), an evaluated erythrocyte sedimentation rate (ESR) (100%) and neurological deficits (47%). The radiological appearances were diagnostic of spinal tuberculosis in less than 50% of cases. Microbiological confirmation of the diagnosis was possible only by direct analysis of tissue or pus, either at operation or from a vertebral biopsy. The difficulty of diagnosing this condition and the implications that this has on the timing and nature of surgery in patients presenting with neurological deficits are discussed.
对21例脊柱结核患者进行了回顾性研究，特别关注诊断方法和所采取的手术治疗。我们发现，该病的临床表现通常与脊柱恶性疾病相似，最常见的表现为背痛（95%）、血沉升高（100%）和神经功能缺损（47%）。在不到50%的病例中，影像学表现可诊断脊柱结核。只有通过手术中或椎体活检时对组织或脓液进行直接分析，才能进行微生物学诊断。本文讨论了诊断该病的困难以及这对出现神经功能缺损患者手术时机和手术性质的影响。
