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KMID : 0378019710140010077
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New Medical Journal
1971 Volume.14 No. 1 p.77 ~ p.85
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Clinical Observation for Differential Diagnosis between Tuberculous Spondylitis and Pyogenic Spondylitis
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Abstract
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Clinical observation of 25 cases of pyogenic´ spondylitis and 50 cases of tuberculous spondylitis, selected at random from total 348 cases of tuberculous ?:spondylitis during the past 6 and half years, was carried out? to study the differential diagnosis.
1. The total incidence ratio between the tuberculous spondylitis and pyogenic spondylitis was 13.9:1, and the incidence was maximum in under 10 age group in spinal tuberculosis, and 10 age group and 20 age group in pyogenic spondylitis. And the sex ratio was 4:1 in pyogenic and 1:1 in tuberculous spondylitis.
2. The site of infection was lumbar spine in 47.5%, thoracic spine in 40.0% and cervical spine in 5% in pyogenic spondylitis, and, in tuberculous spondylitis, thoracic 60.4%, lumber 30.2% and Cervical spine 6.8%.
The involved average number of spine was 1.7 in pyogenic spondylitis and 3.2 in tuberculous spondylitis.
3. The preceding disease was unknown in 68% in pyogenic spondylitis and in 76% in tuberculous spondylitis. In pyogenic spondylitis, 12% of multiple abscess, 12% of osteomyelitis at other skeleton, one case of acute appendicitis and one case of lumbar puncture were noted. In tuberculous spondylitis, 14% of active tuberculosis in lung, 4% of tuberculous pleurisy and 6% of measle were noted.
4. The clinical symptoms and signs consisted of fever, back pain, limitation of motion, spasm of spinal muscle, nerve irritation with monoplegia or paraplegia, tenderness over the involved spinous process in both pyogenic and tuberculous spondylitis. But while in pyogenic spondylitis the fever (64%), back pain (96%), spasm of spinal muscle (56%) and tenderness (96%), were prominent, those were not so prominent in tuberculous spondylitis.
5. The laboratory findings showed marked elevation of erythrosyte sedimentation rate, and some leu￢ko::yto3is with left shiffting of leukocyte in pyogenic spondylitis, Bit in tuberculous spondylitis the total count and differential count of leukocyte were normal in 70%, and the erythrocyte sedimentation rate was elevated in medium grade
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