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Chinese Journal of Antituberculosis ›› 2015, Vol. 37 ›› Issue (3): 307-311.doi: 10.3969/j.issn.1000-6621.2015.03.017

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The development of the spinal tuberculosis with neurological deficit

TANG Kai,DONG Wei-jie,QIN Shi-bing   

  1. Department of Orthopedics, Beijing Chest Hospital, Capital Medical University, Beijing Bone and Joint Tuberculosis Diagnosis and Treatment Center, Beijing 101149, China
  • Received:2015-01-12 Online:2015-03-10 Published:2015-04-03
  • Contact: QIN Shi-bing E-mail:3848474@163.com

Abstract: Neurological deficit is one of the most serious complications of the spinal tuberculosis, which is divided into two types: active type and healed type. The main cause of active neurological deficit are mechanical compression on spinal cord by epidural leision, kyphosis or intervertebral joint dislocation developed from spinal bone destruction, while the cause of healed one are serious kyphosis, the compression of spinal cord by hyperplasia of transverse ridge of bone anterior or fibrous scar left in spinal canal. Good neural recovery happened in patients whose MRI shows normal or nearly normal morphology of spinal cord, with inflammatory edema and no obvious atrophy. While poor neural recovery appears in patients with abnormal morphology of spinal cord (atrophy, myelomalacia and cavity).For the active type patients, drug treatment combined with operation according to the mechanism of neural dysfunction and disease progression characteristics and selecting suitable operation procedures according to the imaging characteristics is conducive to the early recovery of nerve function. While for the healed type patients, the operation is difficulty, bad prognosis on nerve functional recovery. Prevention of severe kyphotic is the key to treatment.

Key words: Tuberculosis, spinal/surgery, Paraplegia, Spinal cord compression