Intraspinal tuberculosis granuloma
Introduction
Introduction to tuberculosis granuloma in the spinal canal Intraspinal tuberculosis refers to tuberculous granuloma located in the epidural or subdural, causing spinal cord dysfunction, clinical features and progressive spinal cord compression symptoms and signs. Some scholars call atypical spinal tuberculosis (atypical spinal tuberculosis), tuberculous granuloma in the spinal canal can be seen at any age, more common in young adults, there is no significant difference in the incidence of male and female, epidural granuloma is more common than subdural granuloma The ratio between the two is about 10:1. basic knowledge The proportion of illness: 0.001% - 0.002% Susceptible people: more common in young adults Mode of infection: respiratory transmission Complications: tuberculosis, bronchiectasis, hemoptysis, emphysema
Cause
Causes of tuberculosis granuloma in the spinal canal
Intraspinal tuberculosis granuloma is also called intraductal tuberculoma. Tuberculosis in the spinal canal is a tuberculosis lesion secondary to other parts of the body. The majority of tuberculosis is spread by blood vessels from other parts of the body to the spinal canal. Within, tuberculous meningitis lesions can also directly spread the invasion of the spinal cord. Intraspinal tuberculosis granuloma is the result of tuberculosis metastasis from the primary lesion, or the result of tuberculosis invading the spine by blood or lymph. The result is spinal column destruction and tuberculous granuloma of the epidural cold abscess.
Prevention
Prevention of tuberculosis granuloma in the spinal canal
Because the lesions are mostly caused by the spread of tuberculosis lesions in other parts of the body, it is essential to give systemic anti-tuberculosis treatment after surgery. The specific effects are as follows:
1. Control the development of tuberculosis lesions and promote the absorption of lesions.
2, to prevent local recurrence and damage to spinal cord function, and promote the recovery of spinal cord function.
3, to prevent the occurrence of tuberculous meningitis, so as not to cause damage to other segments of the spinal cord and the formation of new tuberculosis.
Resting, adequate nutrition, proper outdoor activities, and strengthening the body's resistance are still important conditions to overcome this disease.
Complication
Intraspinal tuberculosis granuloma complications Complications tuberculosis bronchiectasis hemoptysis
Because the disease is caused by tuberculosis infection, the tuberculosis infection in other organs can be caused in the late stage, and tuberculosis, lymphatic tuberculosis and other diseases are caused, and tuberculosis may cause some of the following complications:
1. Bronchiectasis: In the focal lesions of the authorities, after being mechanized by fibrous tissue, the normal tissue structure of the bronchial wall is destroyed, and the elasticity disappears, and localized bronchiectasis is formed. In severe cases, infection or hemoptysis may occur.
2. Hemoptysis: more damage to the tissue of the lesion, inflammation and infiltration, vascular damage, can cause hemoptysis, calcification of the lesion, calcium stone stimulation of tissue, destruction of blood vessels, can also induce hemoptysis, the amount of hemoptysis, related to the size of the damaged blood vessels, light The blood in the sputum is stunned, and the vomiting of the suffocation is even worse.
3. Emphysema: When the lung tissue of the lesion is destroyed, its function is also reduced, and the healthy lung is compensated. When the contemporary compensation exceeds the limit, compensatory emphysema can be formed, and the lung tissue is affected by the pathogen. Invasion and tissue destruction, fibrosis, calcification, pulmonary vesicle formation, etc., can also lead to emphysema.
4. Chronic pulmonary heart disease: extensive pulmonary tuberculosis, lung function, severe pathological changes in the lung structure, resulting in pulmonary hypertension, leading to right ventricular hypertrophy, chronic pulmonary heart disease, when there is heart and lung failure, lung Sexual brain, its consequences are critical.
Symptom
Symptoms of tuberculosis granuloma in the spinal canal Common symptoms Unexplained fever Lymph node tuberculosis Spinal cord compression Thalamic brain bundle Compressed granuloma
The patient's first symptom is mostly localized with localized pain. The patient has other areas such as tuberculosis, tuberculosis, etc., which provides clues for diagnosis. There are slaps and tenderness.
Examine
Examination of tuberculosis granuloma in the spinal canal
1. Cerebrospinal fluid dynamics test showed complete obstruction or incomplete obstruction, cerebrospinal fluid protein content increased to different degrees, the highest can reach 1000mg% or higher, the cell count can be normal, most of the slight increase, the majority of erythrocyte sedimentation rate increased phenomenon.
2. Spinal X-ray showed no bone destruction and no paraspinal cold abscess.
3. Myelography showed scattered subarachnoid obstruction such as irregular filling defect, cup-shaped filling defect or nerve root sleeve deformation. MRI has great diagnostic value for this disease.
Diagnosis
Diagnosis and diagnosis of tuberculosis granuloma in spinal canal
According to the history, signs, cerebrospinal fluid dynamics test and the performance of the line, supplemented by CT, MRI can make a diagnosis.
Different from intraspinal tumors and epidural inflammatory granuloma, schwannomas are more common.
Schwannoma is the most common benign tumor in the tumor of the spinal canal. The course of the disease is long. The main clinical manifestations are pain, paresthesia, dyskinesia and sphincter dysfunction. The ependymoma of the spinal canal develops slowly. Most of them are located in the neck, neck and thoracic segments, and the subdural tumor is larger when the subdural tumor is larger. The first symptom is limb numbness and mutual aid disorder. The early clinical manifestations of tuberculous granuloma and other tumors in the spinal canal are very Similarly, the lumbar puncture shows partial or complete obstruction of the spinal canal, the number of white blood cells in the cerebrospinal fluid is increased or normal, and the sugar and chloride are mostly normal. It is difficult to make a qualitative diagnosis before the operation. In addition, the clinician has limited thinking and relies too much on medical technology examination. If you do not check the cerebrospinal fluid and erythrocyte sedimentation rate, it is more likely to cause misdiagnosis. Therefore, comprehensive diagnosis is needed when diagnosing the disease. Comprehensive analysis should not let go of any details to achieve early diagnosis and timely treatment.
