Wimmer C, Ogon M, Sterzinger W, Landauer F, Stöckl B
Department of Orthopaedic Surgery, University of Innsbruck, Austria.
J Spinal Disord. 1997 Oct;10(5):417-9.
A retrospective follow-up study was performed on 40 patients, in which tuberculous spondylitis was treated conservatively between 1969 and 1985 with orthotic supports for an average of 16 months (range, 10-30 months) and with anti-tuberculous agents. All had persistent back pain, but none had neurological deficits. The mean follow-up period was 17 years (range, 10-26 years). Diagnosis was confirmed histopathologically. The spinal segments involved ranged from T5 to L5. The kyphotic angle was calculated according to Cobb. At final follow-up, 22 patients were pain free, 11 had occasional pain, 6 complained of pain in the morning, and 1 had chronic pain and needed frequent analgesics. Solid bony union was found in 75% of patients. The kyphotic deformity occurred in the thoracic spine with a mean angle of 20 degrees (range, 13-28 degrees) and in the lumbar spine with a mean angle 12 degrees (range, 5-26 degrees). The long-term follow-up of conservative treatment showed only slightly increased kyphosis. Conservative treatment is an alternative to surgical intervention in cases with kyphosis < 35 degrees.
对40例患者进行了回顾性随访研究，这些患者在1969年至1985年间采用矫形支具保守治疗结核性脊柱炎，平均治疗16个月（范围为10 - 30个月），并使用抗结核药物。所有患者均有持续性背痛，但均无神经功能缺损。平均随访期为17年（范围为10 - 26年）。诊断经组织病理学证实。受累脊柱节段范围为T5至L5。后凸角根据Cobb法计算。在最后随访时，22例患者无痛，11例偶尔疼痛，6例主诉晨起疼痛，1例有慢性疼痛且需要频繁使用镇痛药。75%的患者实现了牢固的骨融合。胸椎出现后凸畸形，平均角度为20度（范围为13 - 28度），腰椎平均角度为12度（范围为5 - 26度）。保守治疗的长期随访显示后凸仅略有增加。对于后凸<35度的病例，保守治疗是手术干预的一种替代方法。
