vertebral arch tuberculosis
Introduction
Introduction to vertebral tuberculosis Vertebral tuberculosis refers to lesions limited to pedicles, lamina, spinous processes or transverse processes, rather than lesions secondary to vertebral tuberculosis extending to the pedicle, transverse process or superior and inferior articular processes. The disease is relatively rare, accounting for 0.8% to 1% of spinal tuberculosis, and another group of 10,531 cases of spinal tuberculosis, accounting for 2.3%. Of the 3139 cases of spinal tuberculosis in the Beijing Tuberculosis Control Institute, only 17 cases accounted for 0.4%. There are few reasons for the incidence. Some scholars believe that the small arteries of the vertebral arch are rich in anastomoses, and it is not easy to produce embolism, no weight bearing, less local cancellous bone and rich muscles around them. basic knowledge The proportion of illness: 0.002% Susceptible people: no specific population Mode of infection: non-infectious Complications: aneurysmal bone cysts spinal cord tumors neurofibroma
Cause
The cause of vertebral arch tuberculosis
The incidence of spinal vertebral tuberculosis is high, bone tuberculosis is the first, and vertebral tube tuberculosis is very rare. The vertebral arch tuberculosis is mostly young and young, and the children are less. The reason is the same as other tuberculosis diseases, mainly caused by tubercle bacillus The flow invades and colonizes the site.
Prevention
Pedicle tuberculosis prevention
Active treatment of tuberculosis is the key to the prevention and treatment of this disease. To prevent the spread of tuberculosis and prevent infection, the following points should be noted:
1, tuberculosis patients may have the following symptoms: cough, hemoptysis, low fever, night sweats, chest pain, weight loss, loss of appetite, menstrual disorders, etc., if these symptoms, you should seek medical attention immediately;
2, should adhere to reasonable anti-tuberculosis treatment, the infection is rapidly reduced after treatment;
3, living room, the office often open windows and ventilation, at least half an hour a day;
4, do not spit, you should take disinfection;
5. Close contact with patients with tuberculosis should be screened for tuberculosis;
6, the patient's daily necessities, clothing, bedding, etc. should pay attention to drying;
7, usually pay attention to physical exercise, enhance physical fitness, improve their own immunity;
8, newborns should actively vaccinate BCG.
Complication
Vertebral tuberculosis complications Complications Aneurysmal bone cysts Spinal cord tumors Neurofibroma
Often there is a lump, abscess or sinus, no deformity of the spine, no significant limitation of activity. Most of the abscesses of the vertebral arch tuberculosis are located behind the spine of the lesion, but there are a few abscesses of the transverse process of the lumbar vertebrae, except for the formation of the posterior spine. Invade the psoas muscle attached to the transverse process, forming a psoas abscess and a downward infusion of the axillary abscess.
Symptom
Vertebral tuberculosis symptoms Common symptoms Peripheral area diffuse blunt... Spinal cord compressed abscess vertebral tuberculosis paraplegia
1. The incidence of male and female gender is obviously different. It is more common in young and middle-aged patients. The most common symptoms are thoracic vertebrae, followed by lumbar vertebrae and cervical vertebrae. The lesions are mostly surrounded by the thoracic vertebrae on the three sides of the spinal cord. The spinal cord is compressed from the posterior side. This 25% to 50% of cases are complicated by paraplegia, which is more frequent than vertebral tuberculosis complicated with paraplegia; in addition to the pain of the affected area, nerve root radiation pain is more common.
2. The lesion is close to the body surface, the course of disease is shorter than that of spinal tuberculosis, near the midline of the spine, often with a mass, abscess or sinus, no deformity of the spine, and no significant limitation of activity.
Examine
Vertebral tuberculosis examination
1. X-ray film The X-ray film of the spine can also be expressed as follows when necessary:
(1) The pedicle lesion has a circular elliptical image on the upper side of the superior spinous process of the vertebral body, and the asymmetrical osteolytic damage is unclear.
(2) The bone density of both sides of the spinous process is low.
(3) Spinous process lesions: Compared with the upper and lower normal spinous processes, some or all of the original spinous processes disappeared.
2, CT scan by the high resolution of CT; when the vertebral arch subtle damage can be detected.
Diagnosis
Diagnostic identification of vertebral arch tube
diagnosis
According to the medical history, physical signs and X-ray film performance, if necessary, CT can be used for diagnosis. However, in early cases, there is no abscess and sinus in the paravertebral, and other areas without tuberculosis are difficult to diagnose.
Differential diagnosis
Different from other spinal tuberculosis.
