脊柱结核融合后畸形继发黄韧带骨化:1例报告和综述△

Ossification of the ligamentum flavum secondary to postfusion deformity of spinal tuberculosis: a case report and literature review

摘要:

脊柱结核是肺外结核最常见的形式，约占全身各部位结核的 2%。规范的抗结核治疗是临床治疗脊柱结核的根本途径，而手术治疗亦是临床治疗脊柱结核不可或缺的重要手段。然而，脊柱结核具有难治愈性和易复发性，疗程长达 1.5~2 年， 且经手术治疗后仍有 1.3%~25%的复发率。黄韧带骨化症 （ossification of the ligamentum flavum, OLF） 是一种脊柱韧带异位骨化性疾病，其发病率约占我国人口的 3.8%。OLF 发病隐匿，进展缓慢，容易引起漏诊、误诊及延误治疗，致瘫率极高，手术治疗是唯一有效的治疗方法。脊柱结核继发 OLF 国内外罕有报道，本文报告 1 例脊柱结核融合后畸形继发 OLF 患者，并对相关文献进行综述，以供临床参考。

Abstract:

Spinal tuberculosis is the most common form of extra-pulmonary tuberculosis, accounting for about 2% of tuberculosis in all parts of the body. Standard anti-tuberculosis therapy is the fundamental approach to the clinical treatment of spinal tuberculosis, while surgical treatment is also an indispensable means for the clinical treatment of spinal tuberculosis. However, spinal tuberculosis is difficult to cure and prone to relapse, the course of treatment is as long as 1.5~2 years, and there is still 1.3%~25% recurrence rate after surgical treatment. Ossification of the ligamentum flavum (OLF) is an ectopic ossification of the spinal ligament with incidence 3.8% in Chinese population. The onset of OLF is occult with slow progress, which usually leads missed diagnosis, misdiagnosis and delayed treatment, and very high risk of paralysis in the late stage, however, surgical treatment is the only effective treatment for OLF. The OLF secondary to spinal tuberculosis is rarely reported at home and abroad. This paper reports a case of OLF after spinal tuberculosis fusion, and reviews the relevant literature for providing clinical reference.