What are the symptoms of spinal tuberculosis?

Spinal tuberculosis is very common in life, and it has the highest incidence rate among systemic bone and joint tuberculosis, and is common among adolescents. Spinal tuberculosis has some obvious symptoms. Whenever such symptoms are found, they should be examined and treated as soon as possible. Early treatment is very helpful to the treatment effect.

1. Systemic symptoms

The patient suffers from systemic poisoning symptoms such as fatigue, loss of appetite, low fever in the afternoon, night sweats and weight loss. Occasionally, a few patients may experience acute exacerbation of their condition and develop remittent high fever.

Around 39℃, often misdiagnosed as a severe cold or other acute infection.

2. Local symptoms

(1) Pain

Localized dull pain in the affected area. The symptoms are mild in the early stage, gradually worsen as the disease progresses, and worsen after fatigue or activity, and worsen when riding in a car, coughing, or sneezing.

Severe, relieved by bed rest. The pain worsens at night. If the symptoms suddenly worsen, it is usually due to vertebral compression or lesions involving the nerve roots. The pain can radiate along the spinal nerves, from the upper cervical spine to the back of the head, and from the lower cervical spine to the shoulder or arm.

The thoracic vertebrae radiate along the intercostal nerves to the upper and lower abdomen, and are often misdiagnosed as cholecystitis, pancreatitis, appendicitis, etc. The lower thoracic vertebrae 11 to 12 can radiate to the lower back or buttocks along the inferior gluteal nerve, so most X-ray examinations only take the lumbar spine.

Therefore, lesions of the lower thoracic spine are often missed. Lumbar spine lesions often radiate along the lumbar plexus to the front of the thigh, occasionally involving the back of the leg, and are easily misdiagnosed as disc herniation.

(2) Restricted activities

The soft tissues around the lesions are stimulated by inflammation, causing pain and protective contracture, which affects spinal movement. The cervical and lumbar vertebrae have large range of motion and are easy to

It was found that the thoracic spine had a small range of motion and was not easy to detect. The spine can move in three main directions: flexion and extension, lateral bending and rotation. There is no special fixed position for the patient to actively flex, extend, or scoliosely bend, and any limitations are often readily apparent. Small

If the child does not cooperate, you can make him lie on his back, and you can often find that the hip and knee are flexed; if the hip joint is passively straightened, pain may occur; let the child lie prone, hold his feet with one hand and lift him up, you can see that pain appears immediately, and the waist is stiff.

That is, the prone dorsiflexion test is positive.

(3) Abnormal posture

Patients often have specific postural abnormalities, with different parts of the body and postures. Patients with cervical tuberculosis often have torticollis, forward head tilt, shortened neck and a posture where the mandible is supported by both hands. Patients with thoracic, lumbar, and lumbar tuberculosis have

The patient has a posture with the chest and belly sticking out, and prefers to use an armchair when sitting to reduce the pressure of body weight on the affected vertebrae. A normal person can bend over to pick up objects, but a person who is unable to bend over due to illness and has to flex his hips and knees, support his knees with one hand and pick up objects on the ground with the other hand is called a positive object picking test.

(4) Spinal deformity

It is mainly caused by the invasion and destruction of Mycobacterium tuberculosis, which leads to changes in the morphological structure between vertebrae. The physiological kyphosis of the cervical and lumbar vertebrae may disappear, while the thoracic and thoracolumbar vertebrae are more likely to have kyphosis deformity, which is mostly angular kyphosis and can be felt by touch. Scoliosis is not common or serious. Kyphosis and limited bending are characteristic manifestations of spinal tuberculosis.

(5) Tenderness and percussion pain

Early lesions are deeper and more localized, so local tenderness may not be obvious. The longitudinal percussion method can be used for examination: the patient sits upright, the doctor holds the patient's chest with one hand, and taps the patient's head longitudinally with the other hand. At this time, the patient often has dull pain in the affected vertebra. When the local deformity develops, pressing the posterior kyphotic spinous process with the hand can cause obvious pain.