Summary
We have reviewed the clinical features, together with the radiographs and computerised tomography, in 9 patients with tuberculosis of the vertebral body and neural arch. All presented with paraparesis or paraplegia. The morbidity associated with this disease is so serious that it is essential to have an accurate means of evaluating the lesion as early as possible. Routine radiographs can only indicate the level of the disease and the loss of disc space, but cannot define the full extent of the lesion. Computed tomography shows details of the tuberculous involvement of the neural arch, as well as the vertebral body and spinal canal; the site and extent of the soft tissue lesions can also be seen. This is essential for evaluation of the neural arch involvement which will enable the clinician to select the appropriate treatment, and so prevent neurological complications.
Résumé
La pathologie associée à l'atteinte étendue de l'arc postérieur dans la tuberculose vertébrale de l'adulte rend nécessaire de disposer de moyens précis de détecter précocement cette lésion. Notre expérience et celle d'autres auteurs montre que cela est possible grâce à l'utilisation de la tomodensitométrie (TDM). Les radiographies ordinaires du rachis permettent de préciser le niveau des lésions et l'importance de la destruction discale, mais elles ne permettent pas d'estimer l'extension à la totalité de la vertèbre. Le traitement chirurgical, lorsqu'il est nécessaire, peut être différent en cas du tuberculose vertébrale postérieure de celui que réclament les lésions corporéales. La TDM est essentielle pour préciser cette atteinte en ce qui concerne les indications thérapeutiques.
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Solomon, A., Sacks, A.J. & Goldschmidt, R.P. Neural arch tuberculosis: a morbid disease. International Orthopaedics 19, 110–115 (1995). https://doi.org/10.1007/BF00179971
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DOI: https://doi.org/10.1007/BF00179971