Spinal tuberculosis (Pott's disease): its clinical presentation, surgical management, and outcome. A survey study on 694 patients
Spinal tuberculosis (Pott's disease): its clinical presentation, surgical management, and outcome. A survey study on 694 patients
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DOI：
10.1007/pl00011973
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发表时间：
2001-03-01
影响因子：
2.8
通讯作者：
Turgut, M
中科院分区：
文献类型：
--
作者：
Turgut, M
脊柱结核 (TB)（波特氏病）是最常见也是最危险的结核感染形式。诊断和治疗的延误会导致脊髓受压和脊柱畸形。这项研究调查了1985年至1996年土耳其报告的所有波特氏病病例的数据。总共包括694例病例。在接受评估的患者中，19% 的患者发生在上半年（1985-1990 年），81% 发生在下半年（1991-1996 年）。影响脊柱的结核病通常局限于胸部区域并累及椎体。出现的症状包括腿部无力（69%）、驼背（46%）、疼痛（21%）和可触及肿块（10%）。减压手术加抗结核化疗仍然是治疗波特氏病的最佳方式。 694 名患者中有 414 名获得了随访信息，其中 10 例死亡 (2%)，其中 1 例发生在术中，另外 9 例发生在术后。这项荟萃分析表明，波特氏病在土耳其仍然是一个严重的问题，会导致截瘫。当患者出现提示脊髓受压和脊柱畸形的神经系统检查结果时，应考虑该治疗。在本研究中，得出的结论是，如果在疾病发作时进行紧急减压，则波特氏病引起的神经系统受累相对良性。
Tuberculosis (TB) of the spine (Pott's disease) is both the most common and most dangerous form of TB infection. Delay in establishing diagnosis and management cause spinal cord compression and spinal deformity. This study investigated the data on all cases of Pott's disease reported in Turkey from 1985 to 1996. A total of 694 cases were included. Out of the patients evaluated, 19% were reported in the first half of the period (1985-1990) and 81% in the second half (1991-1996). Tuberculosis affecting the spine was commonly localized in the thoracic region and involved the vertebral body. The presenting symptoms were leg weakness (69%), gibbus (46%), pain (21%), and palpable mass (10%). Decompressive surgery plus anti-TB chemotherapy remains the best mode of therapy for Pott's disease. Follow-up information was available in 414 of the 694 patients and there were ten deaths (2%), one occurring intraoperatively and the other nine postoperatively. This meta-analysis demonstrates that in Turkey Pott's disease remains a serious problem, causing paraplegia. It should be considered when patients present with neurological findings suggesting spinal cord compression and spinal deformity. In the present study, it was concluded that the neurological involvement due to Pott's disease is relatively benign if urgent decompression is performed at the onset of the disease.