BACKGROUND Tuberculosis is among the most devastating infectious diseases worldwide.Spinal tuberculosis is not easy to detect at an early stage,which without effective treatment often leads to spinal deformity and spi...BACKGROUND Tuberculosis is among the most devastating infectious diseases worldwide.Spinal tuberculosis is not easy to detect at an early stage,which without effective treatment often leads to spinal deformity and spinal cord damage which in turn cause complications such as paraplegia and quadriplegia.In this study,we established a model using three concentrations of bacteria and carried out a comprehensive evaluation of the model by imaging,general observations,and histopathological and bacteriological studies.AIM To establish a rabbit model of spinal tuberculosis and examine the effect on the model’s efficacy using different concentrations of Mycobacterium tuberculosis(M.tuberculosis)inoculum.METHODS New Zealand rabbits were randomly divided into experimental,control and blank groups.The experimental and control animals were sensitized with complete Freund′s adjuvant,a hole was drilled beneath the upper endplate of the L6 vertebral body and filled with gelfoam sponge.The experimental group was divided into three subgroups(experimental 1,experimental 2,experimental 3)and infused with M.tuberculosis suspension at various concentrations.The control group was inoculated with saline and the blank group received no treatment.The 12-week post-operative survival rates were 100%,80%and 30%in the experimental groups inoculated with concentrations of 106,107 and 108 CFU/mL bacteria,respectively.RESULTS The survival rate of the control and blank groups was 100%.Vertebral body destruction at 8 weeks in the three experimental groups as determined by X-ray analysis was 33.3%,62.5%and 66.7%,and by computed tomography(CT)and 3-dimensional CT 44.4%,75%and 100%,respectively.At 12 weeks,the figures were 44.4%,75%and 100%by X-ray analysis and 44.4%,100%and 100%by CT and 3-dimensional CT,respectively.All surviving rabbits of the experimental groups had vertebral destruction.The positive bacterial culture rates were 22.2%,75%and 66.7%,respectively,in the experimental groups.After being sensitized with complete Freund's adjuvant,large differences were observed in the extent of spinal tuberculosis after inoculation of the rabbits with different concentrations of H37RV standard M.tuberculosis.CONCLUSION The experimental 1 had a low success rate at establishing an infection.The experimental 3 resulted in high mortality and complication rates.The experimental 2 was optimum for establishing a spinal tuberculosis model based on the high level of symptoms observed and the low rabbit mortality.展开更多
BACKGROUND Spinal tuberculosis(TB),also known as Pott’s spine,remains a significant global health issue,particularly in regions with a high TB burden.The disease presents complex challenges in diagnosis,management,an...BACKGROUND Spinal tuberculosis(TB),also known as Pott’s spine,remains a significant global health issue,particularly in regions with a high TB burden.The disease presents complex challenges in diagnosis,management,and treatment,prompting a growing interest in research over recent years.The advancements in imaging,diagnostics,and treatment strategies have driven an increased focus on publishing clinical outcomes,review articles,and case series related to spinal TB(STB).AIM To perform a bibliometric analysis of STB research published over the last 5 years(2019-2023)to identify trends in publication volume,contributions by country,and the nature of the research being conducted.METHODS A comprehensive bibliometric analysis was conducted using the PubMed database,focusing on research articles published between 2019 and 2023.Keywords such as“spine tuberculosis,”“spinal TB,”“TB spine,”and“Pott’s spine”were utilized to capture relevant publications.Articles were analyzed based on the type of research(e.g.,case reports,review articles,cohort studies,randomized controlled trials[RCTs]),number of citations,and country of origin based on the corresponding author's details.Further subgroup analysis was performed according to the TB burden in various countries to assess research trends in high-burden regions.RESULTS A total of 528 articles met the inclusion criteria for this bibliometric analysis.The majority of articles were published between 2020 and 2023(440/528;83.3%),while the lowest number was published in 2019(88/528;16.7%).India led the global contributions with 25.8%of the total publications,followed by China(19.9%)and the United States(10.4%).Combined,African countries contributed 6.8%of the research on STB.Regarding the type of articles,case reports and case series dominated the literature(353/528;66.9%),followed by review articles(120/528;22.7%)and cohort studies(45/528;8.5%).Only 1.9%(10/528)of the studies were RCTs.Countries such as the United States,Germany,the United Kingdom,and Japan have pioneered the use of artificial intelligence(AI)in the diagnostic processes for STB,while India,China,South Africa,and other countries have been pivotal in conducting clinical trials and improving clinical management strategies.CONCLUSION This bibliometric analysis revealed a significant increase in STB research over the last 5 years,with India and China being the leading contributors.However,most publications are case reports or case series,with a limited number of RCTs.The results highlighted the need for more high-quality research,especially in terms of RCTs and innovations in diagnostic technologies.Additionally,the application of AI to STB diagnostics shows promise in developed countries,while high-burden countries are focusing on clinical trials and management strategies.展开更多
Objective： In the present study, spinal metastatic tumors, brucellar spondylitis and spinal tuberculosis werequantitatively analyzed using dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI） to assess th...Objective： In the present study, spinal metastatic tumors, brucellar spondylitis and spinal tuberculosis werequantitatively analyzed using dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI） to assess thevalue of DCE-MRI in the differential diagnosis of these diseases.Methods： Patients with brucellar spondylitis, spinal tuberculosis or a spinal metastatic tumor （30 cases of each）received conventional MRI and DCE-MRI examination. The volume transfer constant （Ktrans）, rate constant （Kep）,extravascular extracellular volume fraction （Ve） and plasma volume fraction （Vp） of the diseased vertebral bodieswere measured on the perfusion parameter map, and the differences in these parameters between the patients werecompared.Results： For pathological vertebrae in cases of spinal metastatic tumor, brucellar spondylitis and spinaltuberculosis, respectively, the Ktrans values （median ＋ quartile pitch） were 0.989±0.014, 0.720±0.011 and0.317±0.005 min-1; the Kep values were 2.898±0.055, 1.327±0.017 and 0.748±0.006 min-1; the Ve values were0.339±0.008, 0.542±0.013 and 0.428±0.018; the Vp values were 0.048±0.008, 0.035±0.004 and 0.028±0.009; thecorresponding H values were 50.25 （for Ktrans）, 52.47 （for Kep）, 48.33 （for Ve） and 46.56 （for Vp）, and all differenceswere statistically significant （two-sided P〈0.05）.Conclusions： The quantitative analysis of DCE-MRI has a certain value in the differential diagnosis of spinalmetastatic tumor, brucellar spondylitis and spinal tuberculosis.展开更多
This study examined the clinical outcomes of one-stage surgical treatment for patients with spinal tuberculosis via a posterior-only approach. Twenty-four patients with thoracic or lumbar spinal tuberculosis whose les...This study examined the clinical outcomes of one-stage surgical treatment for patients with spinal tuberculosis via a posterior-only approach. Twenty-four patients with thoracic or lumbar spinal tuberculosis whose lesions were confined to adjacent segments were admitted to our hospital and treated. The American Spinal Injury Association（ASIA） impairment scale was used to assess the neurological function. All patients were treated with one-stage surgical treatment via a posterior-only approach. The clinical efficacy was evaluated by the Japanese Orthopaedic Association（JOA） scores and oswestry disability index（ODI） of nerve function. Patients were evaluated preoperatively and postoperatively by measurement of spinal deformity using Cobb angle and radiological examination. All the patients were followed up for 13 to 27 months. They had significantly postoperative improvement in JOA score, ODI and ASIA classification scores. The kyphotic angles were significantly corrected and maintained at the final follow-up. Bone fusion was achieved within 4–12 months. It was concluded that one-stage surgical treatment via a posterior-only approach is effective and feasible for the treatment of spinal tuberculosis.展开更多
Spinal tuberculosis,as one of the most serious forms of extrapulmonary tuberculosis,is one of the primary causes of spinal deformity and paralysis in developing countries.It immensely affects people's quality of l...Spinal tuberculosis,as one of the most serious forms of extrapulmonary tuberculosis,is one of the primary causes of spinal deformity and paralysis in developing countries.It immensely affects people's quality of life with high incidences of deformity and disability.The onset of spinal tuberculosis is related to many factors such as gender,age,environment,habits and hereditary factor.As a genetic factor,gene polymorphism plays an important role in the occurrence and development of tuberculosis.This article reviews the research progress of the susceptibility of spinal tuberculosis and its related gene polymorphisms,in order to provide reference for early prevention and treatment of spinal tuberculosis.展开更多
Objective:To investigate the effect of intensive psycho1ogical nursing on the mood and coping ways of spinal tuberculosis patients.Methods:The clinical data of 102 patients undergoing spinal tuberculosis surgery in ou...Objective:To investigate the effect of intensive psycho1ogical nursing on the mood and coping ways of spinal tuberculosis patients.Methods:The clinical data of 102 patients undergoing spinal tuberculosis surgery in our hospital from February 2017 to January 2020 were retrospectively analyzed.A11 the cases were grouped according to different nursing plans,patients who received routine care were included in the control group(n=50),and the ones with intensive psychological care were included in the observation group(n=52).Compare negative emotions after nursing[assessment using self-assessment scale of anxiety(SAS),depression self-assessment scale(SDS)]and solutions[assessment using medical response questionnaire(MCMQ)]of the two groups.Results:After nursing,the SAs,SDs scores,avoidance and yield scores of the two groups were reduced,and the coping scores were increased,and the change of the observation group was greater than that of the control group,the difference was statistically significant(P<0.05).Conclusion:Spinal tuberculosis surgery patients were treated with intensive psychological care,which can relieve patients'negative emotions,improve solutions and are worthy of clinical use.展开更多
Objective: to explore and analyze the clinical value of CT and MRI in the diagnosis of spinal tuberculosis. Methods: a total of 48 patients with spinal tuberculosis admitted to our hospital from January to December 20...Objective: to explore and analyze the clinical value of CT and MRI in the diagnosis of spinal tuberculosis. Methods: a total of 48 patients with spinal tuberculosis admitted to our hospital from January to December 2020 were selected for the study. All patients received CT and MRI imaging diagnosis successively, and the results of the two imaging examinations were compared and analyzed. Results: the diagnosis results of the two methods for bone disc loss and paravertebral mass are exactly the same, P > 0.05. The detection rate of ligament diffusion, dural cyst and meningeal enhancement by MRI was significantly higher than that by CT, while the detection rate of calcification was significantly lower than that by CT, P<0.05. Conclusion: in the clinical diagnosis of spinal tuberculosis, both CT and MIR have high application value and the diagnostic accuracy of MIR is relatively higher.展开更多
Objective To discuss perioperative features,operative approach and surgical effects of spinal tuberculosis in older patients.Methods Retrospective analysis was conducted to analyze the clinical data of 45 patients wit...Objective To discuss perioperative features,operative approach and surgical effects of spinal tuberculosis in older patients.Methods Retrospective analysis was conducted to analyze the clinical data of 45 patients with spinal展开更多
BACKGROUND: Spinal tuberculosis is a common disease in orthopedic clinical practice; however, it is seldom reported after organ transplantation. The aim of this study was to investigate the diagnosis and treatment of ...BACKGROUND: Spinal tuberculosis is a common disease in orthopedic clinical practice; however, it is seldom reported after organ transplantation. The aim of this study was to investigate the diagnosis and treatment of spinal tuberculosis after organ transplantation. METHOD: Two cases were diagnosed as spinal tuberculosis after liver transplantation and were treated with socarboxazide, rifampicin, streptomycin and ethambutol for more than one year. RESULTS: After treatment with anti-tuberculosis drugs for several months, the symptoms of both patients clearly improved. Back pain disappeared, and erythrocyte sedimentation and body temperature returned to normal. CONCLUSIONS: We should highly suspect spinal tuberculosis if notalgia and night sweats are present after organ transplantation. Anti-tuberculosis therapy is an effective treatment for spinal tuberculosis after organ transplantation.展开更多
Background and Objectives:To explore the effect of nutrition management under ERAS concept in patients with spinal tuberculosis.Methods and Study Design:The study was conducted in an orthopedic ward of a tertiary grad...Background and Objectives:To explore the effect of nutrition management under ERAS concept in patients with spinal tuberculosis.Methods and Study Design:The study was conducted in an orthopedic ward of a tertiary grade A special hospital in Beijing.The patients admitted from January 1,2021 to June 27,2023 were screened for inclusion.The qualified patients were randomized into experimental group or control group.The experimental group received perioperative nutrition management under the concept of ERAS while the control group received routine perioperative management in hospital.The data was collected on the next day of admission,the next day and the sixth day after operation,including laboratory indicators(lymphocyte count,hemoglobin level,etc),intraoperative bleeding volume,postoperative exhaust,defecation time,drainage volume,albumin infusion amount,nutritional risk score,length of stay,hospitalization costs,etc.Univariate analysis and multivariate analysis correcting for gender,age,and baseline values were performed using SPSS24.0.Results:A total of 127 patients with spinal tuberculosis completed the study.Compared with the control group,the intraoperative blood loss(p=0.028)in the experimental group was significantly reduced,the postoperative exhaust time(p=0.012)and defecation time(p=0.012)were significantly shortened,and the nutritional status(p<0.001)was significantly improved.Besides,the results of multivariate analysis are robust after correcting potential confounding factors.Conclusions:Nutrition management under the concept of ERAS is helpful to reduce intraoperative bleeding,promote postoperative flatus and defecation,and improve nutritional status in patients with spinal tuberculosis,which may further improve their clinical outcome and prognosis.展开更多
BACKGROUND Tuberculosis is a chronic infectious disease and an important public health pro-blem.Despite progress in controlling tuberculosis,the incidence of tuberculosis in China is still very high,with 895000 new ca...BACKGROUND Tuberculosis is a chronic infectious disease and an important public health pro-blem.Despite progress in controlling tuberculosis,the incidence of tuberculosis in China is still very high,with 895000 new cases annually.This case report des-cribes the investigation of a case of severe disseminated tuberculosis in a young adult with normal immune function,conducted to ascertain why a Mycobacterium tuberculosis(M.tuberculosis)strain caused such severe disease.CASE SUMMARY A previously healthy 28-year-old woman presented to our hospital with a 1-mo-nth history of fever and fatigue.She was diagnosed with severe disseminated pulmonary tuberculosis,spinal tuberculosis with paravertebral abscesses,and tuberculous meningitis.M.tuberculosis was isolated from bronchoal-veolar lavage fluid.She was treated with standard antituberculous therapy and underwent debridement,bone graft,and internal fixation surgery for spinal tuberculosis.She responded to therapy and regained her ability to walk following the surgery.We analysed the whole-genome sequence of the strain and designated it BLM-A21.Additional M.tuberculosis genomes were selected from the Virulence Factor Database(http://www.mgc.ac.cn/cgi-bin/VFs/genus.cgi?Genus=Mycobacterium)for comparison.An evolutionary tree of the BLM-A21 strain was built using PhyML maximum likelihood software.Further gene analysis revealed that,except for the pks1 gene,BLM-A21 had similar virulence genes to the CDC 1551 and H37Rv strains,which have lower dissemination.CONCLUSION We speculate that the pks1 virulence gene in BLM-A21 may be the key virulence gene responsible for the wide-spread dissemination of M.tuberculosis infection in this previously healthy adult with normal immune function.展开更多
Pott’s spine,commonly known as spinal tuberculosis(TB),is an extrapulmonary form of TB caused by Mycobacterium TB.Pott’s paraplegia occurs when the spine is involved.Spinal TB is usually caused by the hematogenous s...Pott’s spine,commonly known as spinal tuberculosis(TB),is an extrapulmonary form of TB caused by Mycobacterium TB.Pott’s paraplegia occurs when the spine is involved.Spinal TB is usually caused by the hematogenous spread of infection from a central focus,which can be in the lungs or another location.Spinal TB is distinguished by intervertebral disc involvement caused by the same segmental arterial supply,which can result in severe morbidity even after years of approved therapy.Neurological impairments and spine deformities are caused by progressive damage to the anterior vertebral body.The clinical,radiographic,microbiological,and histological data are used to make the diagnosis of spinal TB.In Pott’s spine,combination multidrug antitubercular therapy is the basis of treatment.The recent appearance of multidrug-resistant/extremely drug-resistant TB and the growth of human immunodeficiency virus infection have presented significant challenges in the battle against TB infection.Patients who come with significant kyphosis or neurological impairments are the only ones who require surgical care.Debride-ment,fusion stabilization,and correction of spinal deformity are the cornerstones of surgical treatment.Clinical results for the treatment of spinal TB are generally quite good with adequate and prompt care.展开更多
A kind of hydroxyapatite (HA) high-porous ceramic (HPC) which is used as pharmaceutical carrier for spinal tuberculosis treating is investigated, the structure of HPC is analyzed and physicochemical properties are det...A kind of hydroxyapatite (HA) high-porous ceramic (HPC) which is used as pharmaceutical carrier for spinal tuberculosis treating is investigated, the structure of HPC is analyzed and physicochemical properties are determined. Experiments and clinical application show that when HPC carrying antituberculosis drug was imbedded in the tuberculosis focus, the drug in effective concentration can continuously be released for 27 weeks, also, the drug concentration achieves high local level but low systematic level, thus the curative effect can distinctly enhanced.展开更多
Primary Hodgkin disease （HD） of bone is rare. The recognition on it is relatively confined. Bothcases arising-in male adults were suspected to be Potts disease （spinal tuberculosis） on imaging, and pathologic misd...Primary Hodgkin disease （HD） of bone is rare. The recognition on it is relatively confined. Bothcases arising-in male adults were suspected to be Potts disease （spinal tuberculosis） on imaging, and pathologic misdiagnosed initially. The clinical situations rapidly aggravated. The pathomorphology was remarkable malignant changed. They shared similar process in clinical, radiological and diagnostic process and could be representative. We retrospectively analyzed correlative results of them and review points of distinction from other disease entities that might be confused with it.展开更多
基金Supported by Lanzhou City Science and Technology Development Guiding Plan Project,No.2023-ZD-170Lanzhou Science and Technology Plan Project,No.2023-2-11High-Level Talent Training Project At the 940th Hospital of the Joint Logistics Force,No.2024-G3-5.
文摘BACKGROUND Tuberculosis is among the most devastating infectious diseases worldwide.Spinal tuberculosis is not easy to detect at an early stage,which without effective treatment often leads to spinal deformity and spinal cord damage which in turn cause complications such as paraplegia and quadriplegia.In this study,we established a model using three concentrations of bacteria and carried out a comprehensive evaluation of the model by imaging,general observations,and histopathological and bacteriological studies.AIM To establish a rabbit model of spinal tuberculosis and examine the effect on the model’s efficacy using different concentrations of Mycobacterium tuberculosis(M.tuberculosis)inoculum.METHODS New Zealand rabbits were randomly divided into experimental,control and blank groups.The experimental and control animals were sensitized with complete Freund′s adjuvant,a hole was drilled beneath the upper endplate of the L6 vertebral body and filled with gelfoam sponge.The experimental group was divided into three subgroups(experimental 1,experimental 2,experimental 3)and infused with M.tuberculosis suspension at various concentrations.The control group was inoculated with saline and the blank group received no treatment.The 12-week post-operative survival rates were 100%,80%and 30%in the experimental groups inoculated with concentrations of 106,107 and 108 CFU/mL bacteria,respectively.RESULTS The survival rate of the control and blank groups was 100%.Vertebral body destruction at 8 weeks in the three experimental groups as determined by X-ray analysis was 33.3%,62.5%and 66.7%,and by computed tomography(CT)and 3-dimensional CT 44.4%,75%and 100%,respectively.At 12 weeks,the figures were 44.4%,75%and 100%by X-ray analysis and 44.4%,100%and 100%by CT and 3-dimensional CT,respectively.All surviving rabbits of the experimental groups had vertebral destruction.The positive bacterial culture rates were 22.2%,75%and 66.7%,respectively,in the experimental groups.After being sensitized with complete Freund's adjuvant,large differences were observed in the extent of spinal tuberculosis after inoculation of the rabbits with different concentrations of H37RV standard M.tuberculosis.CONCLUSION The experimental 1 had a low success rate at establishing an infection.The experimental 3 resulted in high mortality and complication rates.The experimental 2 was optimum for establishing a spinal tuberculosis model based on the high level of symptoms observed and the low rabbit mortality.
文摘BACKGROUND Spinal tuberculosis(TB),also known as Pott’s spine,remains a significant global health issue,particularly in regions with a high TB burden.The disease presents complex challenges in diagnosis,management,and treatment,prompting a growing interest in research over recent years.The advancements in imaging,diagnostics,and treatment strategies have driven an increased focus on publishing clinical outcomes,review articles,and case series related to spinal TB(STB).AIM To perform a bibliometric analysis of STB research published over the last 5 years(2019-2023)to identify trends in publication volume,contributions by country,and the nature of the research being conducted.METHODS A comprehensive bibliometric analysis was conducted using the PubMed database,focusing on research articles published between 2019 and 2023.Keywords such as“spine tuberculosis,”“spinal TB,”“TB spine,”and“Pott’s spine”were utilized to capture relevant publications.Articles were analyzed based on the type of research(e.g.,case reports,review articles,cohort studies,randomized controlled trials[RCTs]),number of citations,and country of origin based on the corresponding author's details.Further subgroup analysis was performed according to the TB burden in various countries to assess research trends in high-burden regions.RESULTS A total of 528 articles met the inclusion criteria for this bibliometric analysis.The majority of articles were published between 2020 and 2023(440/528;83.3%),while the lowest number was published in 2019(88/528;16.7%).India led the global contributions with 25.8%of the total publications,followed by China(19.9%)and the United States(10.4%).Combined,African countries contributed 6.8%of the research on STB.Regarding the type of articles,case reports and case series dominated the literature(353/528;66.9%),followed by review articles(120/528;22.7%)and cohort studies(45/528;8.5%).Only 1.9%(10/528)of the studies were RCTs.Countries such as the United States,Germany,the United Kingdom,and Japan have pioneered the use of artificial intelligence(AI)in the diagnostic processes for STB,while India,China,South Africa,and other countries have been pivotal in conducting clinical trials and improving clinical management strategies.CONCLUSION This bibliometric analysis revealed a significant increase in STB research over the last 5 years,with India and China being the leading contributors.However,most publications are case reports or case series,with a limited number of RCTs.The results highlighted the need for more high-quality research,especially in terms of RCTs and innovations in diagnostic technologies.Additionally,the application of AI to STB diagnostics shows promise in developed countries,while high-burden countries are focusing on clinical trials and management strategies.
基金funded by the National Natural Science Foundation of China (No. 81460259)
文摘Objective： In the present study, spinal metastatic tumors, brucellar spondylitis and spinal tuberculosis werequantitatively analyzed using dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI） to assess thevalue of DCE-MRI in the differential diagnosis of these diseases.Methods： Patients with brucellar spondylitis, spinal tuberculosis or a spinal metastatic tumor （30 cases of each）received conventional MRI and DCE-MRI examination. The volume transfer constant （Ktrans）, rate constant （Kep）,extravascular extracellular volume fraction （Ve） and plasma volume fraction （Vp） of the diseased vertebral bodieswere measured on the perfusion parameter map, and the differences in these parameters between the patients werecompared.Results： For pathological vertebrae in cases of spinal metastatic tumor, brucellar spondylitis and spinaltuberculosis, respectively, the Ktrans values （median ＋ quartile pitch） were 0.989±0.014, 0.720±0.011 and0.317±0.005 min-1; the Kep values were 2.898±0.055, 1.327±0.017 and 0.748±0.006 min-1; the Ve values were0.339±0.008, 0.542±0.013 and 0.428±0.018; the Vp values were 0.048±0.008, 0.035±0.004 and 0.028±0.009; thecorresponding H values were 50.25 （for Ktrans）, 52.47 （for Kep）, 48.33 （for Ve） and 46.56 （for Vp）, and all differenceswere statistically significant （two-sided P〈0.05）.Conclusions： The quantitative analysis of DCE-MRI has a certain value in the differential diagnosis of spinalmetastatic tumor, brucellar spondylitis and spinal tuberculosis.
文摘This study examined the clinical outcomes of one-stage surgical treatment for patients with spinal tuberculosis via a posterior-only approach. Twenty-four patients with thoracic or lumbar spinal tuberculosis whose lesions were confined to adjacent segments were admitted to our hospital and treated. The American Spinal Injury Association（ASIA） impairment scale was used to assess the neurological function. All patients were treated with one-stage surgical treatment via a posterior-only approach. The clinical efficacy was evaluated by the Japanese Orthopaedic Association（JOA） scores and oswestry disability index（ODI） of nerve function. Patients were evaluated preoperatively and postoperatively by measurement of spinal deformity using Cobb angle and radiological examination. All the patients were followed up for 13 to 27 months. They had significantly postoperative improvement in JOA score, ODI and ASIA classification scores. The kyphotic angles were significantly corrected and maintained at the final follow-up. Bone fusion was achieved within 4–12 months. It was concluded that one-stage surgical treatment via a posterior-only approach is effective and feasible for the treatment of spinal tuberculosis.
基金Fund Project:Traditional Chinese Medicine Research Project of Hubei Provincial Health Commission(ZY2019F025)the Clinical Research Supported by Wu Jieping Medical Foundation(No.320.6750.17566)。
文摘Spinal tuberculosis,as one of the most serious forms of extrapulmonary tuberculosis,is one of the primary causes of spinal deformity and paralysis in developing countries.It immensely affects people's quality of life with high incidences of deformity and disability.The onset of spinal tuberculosis is related to many factors such as gender,age,environment,habits and hereditary factor.As a genetic factor,gene polymorphism plays an important role in the occurrence and development of tuberculosis.This article reviews the research progress of the susceptibility of spinal tuberculosis and its related gene polymorphisms,in order to provide reference for early prevention and treatment of spinal tuberculosis.
文摘Objective:To investigate the effect of intensive psycho1ogical nursing on the mood and coping ways of spinal tuberculosis patients.Methods:The clinical data of 102 patients undergoing spinal tuberculosis surgery in our hospital from February 2017 to January 2020 were retrospectively analyzed.A11 the cases were grouped according to different nursing plans,patients who received routine care were included in the control group(n=50),and the ones with intensive psychological care were included in the observation group(n=52).Compare negative emotions after nursing[assessment using self-assessment scale of anxiety(SAS),depression self-assessment scale(SDS)]and solutions[assessment using medical response questionnaire(MCMQ)]of the two groups.Results:After nursing,the SAs,SDs scores,avoidance and yield scores of the two groups were reduced,and the coping scores were increased,and the change of the observation group was greater than that of the control group,the difference was statistically significant(P<0.05).Conclusion:Spinal tuberculosis surgery patients were treated with intensive psychological care,which can relieve patients'negative emotions,improve solutions and are worthy of clinical use.
文摘Objective: to explore and analyze the clinical value of CT and MRI in the diagnosis of spinal tuberculosis. Methods: a total of 48 patients with spinal tuberculosis admitted to our hospital from January to December 2020 were selected for the study. All patients received CT and MRI imaging diagnosis successively, and the results of the two imaging examinations were compared and analyzed. Results: the diagnosis results of the two methods for bone disc loss and paravertebral mass are exactly the same, P > 0.05. The detection rate of ligament diffusion, dural cyst and meningeal enhancement by MRI was significantly higher than that by CT, while the detection rate of calcification was significantly lower than that by CT, P<0.05. Conclusion: in the clinical diagnosis of spinal tuberculosis, both CT and MIR have high application value and the diagnostic accuracy of MIR is relatively higher.
文摘Objective To discuss perioperative features,operative approach and surgical effects of spinal tuberculosis in older patients.Methods Retrospective analysis was conducted to analyze the clinical data of 45 patients with spinal
文摘BACKGROUND: Spinal tuberculosis is a common disease in orthopedic clinical practice; however, it is seldom reported after organ transplantation. The aim of this study was to investigate the diagnosis and treatment of spinal tuberculosis after organ transplantation. METHOD: Two cases were diagnosed as spinal tuberculosis after liver transplantation and were treated with socarboxazide, rifampicin, streptomycin and ethambutol for more than one year. RESULTS: After treatment with anti-tuberculosis drugs for several months, the symptoms of both patients clearly improved. Back pain disappeared, and erythrocyte sedimentation and body temperature returned to normal. CONCLUSIONS: We should highly suspect spinal tuberculosis if notalgia and night sweats are present after organ transplantation. Anti-tuberculosis therapy is an effective treatment for spinal tuberculosis after organ transplantation.
文摘Background and Objectives:To explore the effect of nutrition management under ERAS concept in patients with spinal tuberculosis.Methods and Study Design:The study was conducted in an orthopedic ward of a tertiary grade A special hospital in Beijing.The patients admitted from January 1,2021 to June 27,2023 were screened for inclusion.The qualified patients were randomized into experimental group or control group.The experimental group received perioperative nutrition management under the concept of ERAS while the control group received routine perioperative management in hospital.The data was collected on the next day of admission,the next day and the sixth day after operation,including laboratory indicators(lymphocyte count,hemoglobin level,etc),intraoperative bleeding volume,postoperative exhaust,defecation time,drainage volume,albumin infusion amount,nutritional risk score,length of stay,hospitalization costs,etc.Univariate analysis and multivariate analysis correcting for gender,age,and baseline values were performed using SPSS24.0.Results:A total of 127 patients with spinal tuberculosis completed the study.Compared with the control group,the intraoperative blood loss(p=0.028)in the experimental group was significantly reduced,the postoperative exhaust time(p=0.012)and defecation time(p=0.012)were significantly shortened,and the nutritional status(p<0.001)was significantly improved.Besides,the results of multivariate analysis are robust after correcting potential confounding factors.Conclusions:Nutrition management under the concept of ERAS is helpful to reduce intraoperative bleeding,promote postoperative flatus and defecation,and improve nutritional status in patients with spinal tuberculosis,which may further improve their clinical outcome and prognosis.
基金Supported by the Research on Intelligent Recommendation Decision Model of Geriatrics Based on Big Data,No.2021CX01010136.
文摘BACKGROUND Tuberculosis is a chronic infectious disease and an important public health pro-blem.Despite progress in controlling tuberculosis,the incidence of tuberculosis in China is still very high,with 895000 new cases annually.This case report des-cribes the investigation of a case of severe disseminated tuberculosis in a young adult with normal immune function,conducted to ascertain why a Mycobacterium tuberculosis(M.tuberculosis)strain caused such severe disease.CASE SUMMARY A previously healthy 28-year-old woman presented to our hospital with a 1-mo-nth history of fever and fatigue.She was diagnosed with severe disseminated pulmonary tuberculosis,spinal tuberculosis with paravertebral abscesses,and tuberculous meningitis.M.tuberculosis was isolated from bronchoal-veolar lavage fluid.She was treated with standard antituberculous therapy and underwent debridement,bone graft,and internal fixation surgery for spinal tuberculosis.She responded to therapy and regained her ability to walk following the surgery.We analysed the whole-genome sequence of the strain and designated it BLM-A21.Additional M.tuberculosis genomes were selected from the Virulence Factor Database(http://www.mgc.ac.cn/cgi-bin/VFs/genus.cgi?Genus=Mycobacterium)for comparison.An evolutionary tree of the BLM-A21 strain was built using PhyML maximum likelihood software.Further gene analysis revealed that,except for the pks1 gene,BLM-A21 had similar virulence genes to the CDC 1551 and H37Rv strains,which have lower dissemination.CONCLUSION We speculate that the pks1 virulence gene in BLM-A21 may be the key virulence gene responsible for the wide-spread dissemination of M.tuberculosis infection in this previously healthy adult with normal immune function.
文摘Pott’s spine,commonly known as spinal tuberculosis(TB),is an extrapulmonary form of TB caused by Mycobacterium TB.Pott’s paraplegia occurs when the spine is involved.Spinal TB is usually caused by the hematogenous spread of infection from a central focus,which can be in the lungs or another location.Spinal TB is distinguished by intervertebral disc involvement caused by the same segmental arterial supply,which can result in severe morbidity even after years of approved therapy.Neurological impairments and spine deformities are caused by progressive damage to the anterior vertebral body.The clinical,radiographic,microbiological,and histological data are used to make the diagnosis of spinal TB.In Pott’s spine,combination multidrug antitubercular therapy is the basis of treatment.The recent appearance of multidrug-resistant/extremely drug-resistant TB and the growth of human immunodeficiency virus infection have presented significant challenges in the battle against TB infection.Patients who come with significant kyphosis or neurological impairments are the only ones who require surgical care.Debride-ment,fusion stabilization,and correction of spinal deformity are the cornerstones of surgical treatment.Clinical results for the treatment of spinal TB are generally quite good with adequate and prompt care.
文摘A kind of hydroxyapatite (HA) high-porous ceramic (HPC) which is used as pharmaceutical carrier for spinal tuberculosis treating is investigated, the structure of HPC is analyzed and physicochemical properties are determined. Experiments and clinical application show that when HPC carrying antituberculosis drug was imbedded in the tuberculosis focus, the drug in effective concentration can continuously be released for 27 weeks, also, the drug concentration achieves high local level but low systematic level, thus the curative effect can distinctly enhanced.
文摘Primary Hodgkin disease （HD） of bone is rare. The recognition on it is relatively confined. Bothcases arising-in male adults were suspected to be Potts disease （spinal tuberculosis） on imaging, and pathologic misdiagnosed initially. The clinical situations rapidly aggravated. The pathomorphology was remarkable malignant changed. They shared similar process in clinical, radiological and diagnostic process and could be representative. We retrospectively analyzed correlative results of them and review points of distinction from other disease entities that might be confused with it.
