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Rehabilitation Practice and Science

Translated Title

脊椎結核症病例報告

Abstract

The majority of tuberculosis bacillus infection is in the lung. Although the incidence of infection in the skeletal system is low, spinal tuberculosis is on important cause of hack pain in the Rehabilitation Outpatient Department because it is the most skeletal site affected.During the past year, we managed three cases of spinal tuberculosis. The characteristics of these patients were 1) backache over the thoracolum-bar junction with knocking pain, 2) fair response to analgesics and physical modalities and Paras-pinal abscess noted on MRI (Magnetic Resonance Image) examination. Chemotherapy and surgery were performed in two cases with significant neurological symptoms (weakness and numbness of lower extremities). Case 1 was a 74 year-old male patient with lesion site over the tenth thoracic spine. Spinal tuberculosis was suspected after MRI examination. Surgical intervention was performed Wthin 2 weeks and spinal tuberculosis was proved by histological examination. The patient could ambulate independently after rehabilitation program. Case 2 was a 70 yearold male with a lesion located at the second and third lumbar spine- The diagnosis of spinal tuberculosis was made three months after onset of backache owing to doctor shopping. Severe lumbar spondylosis was noted in this patient. The patient is bedridden at present in spite of rehabilitation therapy. Another case was a 44 year-old female whose lesion was located at the second and third lumbar spine. Two months after the onset of backache, MRI was arranged. It revealed a destroyed and narrowed intervertebral disc space between the second and third lumbar spine with a perivertebral soft tissue mass. No significant neurological signs were noted. The patient refused surgical intervention, so only chemotherapy was given. Backache improved and daily living activities were near normal after therapy. In summary: 1) Tumor and tuberculosis should be taken into consideration in the backache patients with uncommon locations accompanyed by knocking pain and poor response to analgesics and physical therapy. 2) MRI is of great help in both the diagnosis of spinal tuberculosis and prediction of neurologic complications. 3) The earlier diagnosis and treatment are performed, the better prognosis of the patient.

Language

Traditional Chinese

First Page

91

Last Page

96

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