結核性脊椎炎および関節結核に関する疫学的調査

Epidemiological Survey in Tuberculous Spondylitis and Arthritis in Japan

　結核性脊椎炎および関節結核に関する整形外科医に対する全国的なアンケート調査を行い，治療の現状と問題点について検討した．アンケートの結果，都市部の施設での治療例が多くみられたが，結核発生率の地域差と手術治療ができる施設の偏在を反映したものと考えられた．診断に関しては，初期診断が困難・誤診率が高いとする意見が大半を占めていた．治療に関しては脊椎前方固定術単独が最も多く，インストゥルメンテーションの適応については慎重である傾向が伺えた．調査を通じて診断，治療，施設などの問題点が浮き彫りになったと言える．

　To evaluate the present status and problems about treatment for osteoarticular tuberculosis in Japan, a nationwide questionnaire survey for orthopaedic surgeons was done.　The majority of the patients were treated in urban facilities which might be influenced by the regional difference in incidence of tuberculosis and the lack of the appropriate facilities for surgical treatment.　Misdiagnosis was regarded as common and early diagnosis was still regarded difficult.　Anterior spinal fusion was most common surgical treatment of all and application of spinal instrumentation was still uncommon.　The problems in diagnosis, treatment and facilities for osteoarticular tuberculosis were elucidated by this survey.