Spinal Tuberculosis in Adults: A Study of 103 Cases in a Developed Country, 1980-1994

作者：Édouard Pertuiset, Johann Beaudreuil, Frédéric Lioté, A Horusitzky, Farid Kemiche, Pascal Richette, Dominique Clerc-Wyel, Isabelle Cerf-Payrastre, Henri Dorfmann, Jacques Glowinski, Jacques Crouzet, Thomas Bardin, Olivier Meyer, Antoine Dryll, Jean-Marc Ziza, Marcel-Francis Kahn, Daniel J. Kuntz · 发表于：Medicine · 年份：1999 · DOI：10.1097/00005792-199909000-00003 · 被引用次数：339 · 研究领域：Infectious Diseases and Tuberculosis、Orthopedic Infections and Treatments、Amoebic Infections and Treatments

Spinal tuberculosis (TB) accounts for about 2% of all cases of TB. New methods of diagnosis such as magnetic resonance imaging (MRI) or percutaneous needle biopsy have emerged. Two distinct patterns of spinal TB can be identified, the classic form, called spondylodiscitis (SPD) in this article, and an increasingly common atypical form characterized by spondylitis without disk involvement (SPwD). We conducted a retrospective study of patients with spinal TB managed in the area of Paris, France, between 1980 and 1994 with the goal of defining the characteristics of spinal TB and comparing SPD to SPwD. The 103 consecutive patients included in our study had TB confirmed by bacteriologic and/or histologic studies of specimens from spinal or paraspinal lesions (93 patients) or from extraspinal skeletal lesions (10 patients). Sixty-eight percent of patients were foreign-born subjects from developing countries. None of our patients was HIV-positive. SPD accounted for 48% of cases and SPwD for 52%. Patients with SPwD were younger and more likely to be foreign-born and to have multiple skeletal TB lesions. Neurologic manifestations were observed in 50% of patients, with no differences between the SPD and SPwD groups. Of the 44 patients investigated by MRI, 6 had normal plain radiographs; MRI was consistently positive and demonstrated epidural involvement in 77% of cases. Bacteriologic and histologic yields were similar for surgical biopsy (n = 16) and for percutaneous needle aspiration...