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Tuberculous Spondylitis Masaki Fujita 1 , Masashi Saito 2 , Nobuhiko Niiro 1 , Mizuo Itoda 1 , Takeshi Minowa 1 1Department of Orthopaedic Surgery,National Sapporo Minami Hospital 2Department of Orthopaedic Surgery,National Murayama Hospital Keyword: tuberculosis(結核) , tuberculous spondylitis(脊椎カリエス) , spinal tuberculosis(結核性脊椎炎) pp.293-300
Published Date 2003/3/1
DOI https://doi.org/10.11477/mf.1408100657
  • Abstract
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There has been a marked decrease in the number of patients with tuberculous spondylitis in Japan in recent years,and as a result only a few orthopaedic surgeons have had experience in treating it.In fact,since hardly any orthopaedic surgeons can quickly make a correct diagnosis,the condition of the patients rapidly deteriorats.Because of this,all orthopaedic surgeons should keep the existence of disease in mind.

 On plain radiographs it is important to check for the signs such as verterbral disc space narrowing,irregularity of the vertebral end-plates,and marginal bone destruction,and if any of these signs is detected,tuberculous spondylitis should be placed at the top of the list of the differential diagnosis.CT scanning is perhaps a more useful method of detecting the disease,and if the scans reveal a paravertebral soft tissue mass,destruction of the posterior wall of a vertebral body,or soft tissue calcification in the mass,tuberculous spondylitis should be suspected.MRI provides important evidence for the diagnosis of this disease,and a heterogeneous pattern of intensity of the bone marrow in the vertebral body involved and rim enhancement with gadolinium-DTPA are valvable clves.Recently there have been many reports of instrumentation surgery for tuberculous spondylitis,but because of the risk of recurrence care should be exercised when using instruments,especially on the vertebral body.

 Use of at least 3 different antitubercular drugs is the basic treatment for tuberculous spondylitis.


Copyright © 2003, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1286 印刷版ISSN 0557-0433 医学書院

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