当院での結核性脊椎炎の診断と治療

抄録

Twenty-nine patients with a diagnosis of tuberculous spondylitis were reviewed regarding clinical features, radiographic findings and surgical outcome. 14 (48%) patients were aged in their fifties and sixties. Neurologic complications had occurred in 9 (31%) patients, 8 of whom could not walk. In five patients, the neurologic deficit almost recovered to normal. On radiographic evaluation, bony destruction over the half of the vertebral body was apparent in 29 (88%), but bony bridge and sclerotic changes in the involved vertebrae were not present in non-treated cases at admission. Tomography can be useful for detection of subtle changes in the vertebral body. We operated on 29 cases (33 lesions), of which 18 lesions were treated by curretage and anterior spinal fusion, 14 received ahterior spinal fusion and posterior instrumentation combined, one received only posterior fusion with instrumentation. All cases with anterior spinal fusion and bone graft achieved stable union with satisfactory results.