| 摘要 |
Background: Tuberculosis (TB) remains a prevalent infectious disease in eastern
Taiwan, and, tuberculous spondylitis has a great impact on the quality of daily life.
Aim: To investigate the demographics, clinical manifestation and treatment in eastern Taiwan.
Methods: From January 1988 to December 2010, the medical records were retrospectively reviewed of adult patients with a diagnosis of TB of the spine. Patients were enrolled with positive acid fast stain, culture results, or characteristic pathologic findings. Demographic data, clinical manifestations, and the treatments were analyzed.
Results: During the period, 39 patients (24 women and 15 men) with TB of the spine were identified; the mean age was 54 years. The lumbar spine (26 patients, 63%) was the most commonly involved site, followed by the thoracic spine (20 patients, 49%). The TB spine mostly involved two vertebral segments, as noticed in 21 (51%) patients with spinal TB. There were six patients (15%) with at least five segments involved. Concomitant pulmonary TB was found in seven patients. Most patients received surgical correction plus a combination of anti-TB drugs (isoniazid, rifampin, ethambutol, pyrazinamide), and seven patients received medical treatment only because of high surgical risk. Most commonly, surgery was performed with a combination of anterior and posterior approaches. Most patients recovered well after surgery.
Conclusion: Patients with TB of the spine may involve more than one spinal segment. On the basis of the four-drug combination in the initial phase followed by treatment for up to 12 months, along with appropriate surgical correction, can lead to good clinical outcomes with acceptable risks. |
