結核性脊椎炎における麻痺発症因子の検討

Factors Associated with Myelopathy in Spinal Tuberculosis

　結核性脊椎炎のPott麻痺発症関連因子を検討した．結核性脊椎炎症例49例(麻痺群22例，非麻痺群27例)に対し，患者背景については性別・年齢・肺結核の有無・標準的化学療法の可否・CRP・栄養状態・罹病期間を，画像については病巣脊柱管内占拠率，圧迫要素，最狭窄高位，罹患椎体数，椎体周囲膿瘍の範囲，MRI髄内輝度変化，後弯角，不安定性を群間で比較したところ，麻痺群は栄養状態不良で，画像的に病巣脊柱管内占拠率が高く，MRI髄内輝度変化を多く認めた．麻痺の重症度を決定する因子は明らかでなかった．

　To identity factors associated with Pott's disease, 49 spinal tuberculosis patients were classified into a group of 22 patients with a neurological deficit and a group of 27 patients with no neurological deficits, and their clinical findings (gender, age, pulmonary tuberculosis, antituberculous chemotherapy, CRP, nutritional status, and duration of disease) and radiographic findings (degree of canal encroachment, pathology and level of dural compression, number of affected vertebral bodies, range of paravertebral abscesses, signals in the spinal cord on MRI, kyphotic angle, and spinal instability) were compared.　The results showed that malnutrition, severe canal encroachment, and abnormal signal within the spinal cord on MRI were associated with neurological complications.　Factors associated with the degree of neurological deficit were unclear because the study population was too small.