脊柱结核后凸畸形发生的相关因素及研究进展

Related factors and research progress of kyphosis of spinal tuberculosis

脊柱结核是导致严重脊柱后凸畸形的常见原因之一。脊柱结核后凸畸形的形成是受多因素影响的,主要包括感染时年龄、累计节段数、治疗前椎体丢失高度以及"脊柱危险体征"等。尽管抗结核药物的使用取得了良好的疗效,但对于药物治疗后治愈的脊柱结核患者,后凸畸形会继续进展,逐渐发展成为严重的后凸畸形。进而出现外观、心理、肋骨-骨盆撞击、心肺功能障碍以及神经脊髓压迫等一些列问题。治疗前椎体丢失高度和"脊柱危险体征"的X线征象有助于预测未来畸形发生的严重程度。因此,全面认识脊柱结核后凸畸形的形成以及尽早根据病变的具体情况,个体化选择手术方式,可以有效阻止后凸畸形的形成并减少脊髓神经功能损伤和迟发性瘫痪的发生率。

Spinal tuberculosis is one of the common causes of severe kyphosis.The formation of spinal tuberculosis kyphosis is multi-factors,including age at the time of infection,the cumulative number of segments,the height of vertebral body loss before treatment,and"spine danger signs".Although the use of anti-tuberculosis drugs has achieved good results,for patients with spinal tuberculosis cured by drug treatment,the kyphosis will continue to progress and gradually develop into a severe kyphosis.Then there are a series of problems such as appearance,psychology,rib-pelvic impingement,cardiopulmonary dysfunction,and nerve and spinal cord compression.The X-ray signs of the height of the vertebral body loss and"spine danger signs"before treatment can help predict the severity of future deformities.Therefore,a comprehensive understanding of the formation of kyphosis of spinal tuberculosis and individualized selection of surgical methods according to the specific conditions of the disease as soon as possible can effectively prevent the formation of kyphosis and reduce the incidence of neurological damage and delayed paralysis.