Sinus phase

Introduction Spinal tuberculosis complicated with sinus is one of the most common complications of spinal tuberculosis. The incidence rate was 18 before the onset of anti-tuberculosis drugs. The longer the sinus, the shorter the life, and the mortality rate was as high as 34%. Anti-tuberculosis drugs, especially with the introduction of rifampic drugs, have a marked decline in their incidence. Patients with this disease may have typical manifestations of tuberculosis, and pus outflows may be found at the fistula.

Cause

Causes of sinus formation: Most patients with this disease are self-ruptured on the surface abscess, and the sinus is formed after operation, indicating that the operation period is not properly selected, and the lesion may still be in the stage of exudative disease.

an examination

Related inspection

Tuberculin test (OT, PPD) tuberculosis test

Patients with this disease may have typical manifestations of tuberculosis, and pus outflow may be found in the fistula. X-ray examination may reveal obvious destruction of the vertebral body, including dead bone, cheese substance, or flow abscess. In 25% of cases, the sinus secretion of tuberculosis culture was positive, which can be regarded as one of the sources of tuberculosis infection. Combined with bacteriological examination is not difficult to diagnose.

Differential diagnosis

1, sinus tract: patients with tethered cord syndrome, especially children, should be alert to the clinical manifestations of cutaneous sinus or subcutaneous mass. Tethered cord syndrome (TCS) is a syndrome in which a spinal cord or a cone is pulled due to various congenital and acquired causes, resulting in a series of neurological dysfunctions and malformations. Because the spinal cord is pulled more often in the lumbosacral medulla, causing the cone to be abnormally low, it is also called the lower spinal cord.

2, lower back sinus: congenital skin-like sinus, common in the head pillow or waist, back midline. Patients with cochlear spina bifida can have both endothelium-like or epithelial congenital masses. This sinus is more common in the lumbosacral region, and the local soft tissue can be slightly raised. The skin around the small hole in the sinus can be seen as pale red pigmentation and surrounded by tufts. Occasionally fine hair protrudes from the small hole. Sometimes a little liquid seeps out. When secondary infection, local redness, swelling, and pain.

3, the formation of the sinus of the appendix: the sinus sinus and the hair follicle are a chronic sinus or cyst in the soft tissue of the intercondylar rupture of the appendix. The hair is characteristic. It can also be manifested as an acute abscess in the appendix. After piercing, it forms a chronic sinus, or it is temporarily healed, and finally pierced, so it can be repeated. The cyst is accompanied by granulation tissue, fibrous hyperplasia, often containing a tuft of hair. Although the disease can be seen after birth, it usually occurs 20 to 30 years after puberty, and symptoms appear due to increased activity of hair and fat glands.

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