重视脊柱特殊类型感染问题

To draw close attention to the specific types of spinal infection

本期共刊出了3篇有关脊柱特殊类型感染的论著和综述,其临床意义值得关注。这些文章涉及脊柱结核和脊柱布氏杆菌病,这两种脊柱特殊类型感染的发病率呈逐年上升趋势,已经成为需要引起重视和观察研究的健康问题。以脊柱结核为例,虽然前些年我国肺结核发病率呈下降趋势,但受人口增加、人口老龄化、耐药菌、

The recent rising trend of the morbidity of tuberculosis of spine and brucellosis has become a major healthcare issue which should draw close attention from the public. The tuberculosis of bone and joint is the most common type of extra pulmonary tuberculosis with a percentage from 5% to 10% out of the whole tuberculosis infected population. Fifty percent of the patients with the tuberculosis of bone and joint have the spine tuberculosis. It should be noticed that the ghost of tuberculosis has staged a comeback silently and globally in spite of the great advance of both medical science and technology and development of antituberculotic drugs. Unfortunately, this healthcare issue has not been brought to the attention of both the public and healthcare administrations to introduce a preferential policy to help these patients. Therefore, we should not only pay close attention to the recent high morbidity of tuberculosis, but also fight with the new challenges of these specific types of tuberculosis in the poverty and aged populations. The brucellosis frequently involves spine, resulting in brucellosis spondylitis which may manifest no specific clinical symptoms and signs and leads to the difficulty in clinical diagnosis and misdiagnosis. In the clinical practice of the treatment for brucellosis spondylitis, the principles should be followed as below：（ 1） Careful and rational diagnostic analysis;（ 2） Individualized therapeutic strategy;（ 3） Correct indications for surgery and restraint of aggressive surgical option. The author briefly reviewed the clinical features of the above described 2 diseases, including clinical and imaging diagnosis and differential diagnosis.