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a chronic inflammation of man affecting the vertebrae. Spondylitis is usually caused by tuberculosis; it may sometimes be caused by other infections, for example, by staphylococcal or syphilitic infections.
Tuberculous spondylitis primarily affects children under ten years of age, with the thoracic vertebrae being involved in 60 percent of cases. The causative agent is carried with the blood flow to the highly vascularized spongy substance of the bone of a vertebra. Penetrating the spongy substance, it stimulates the development of the tuberculous process. Trauma to the spine does not cause spondylitis, although it does help to exacerbate the disease and manifest the latent process. A tuberculous granuloma that forms in a vertebral body causes the gradual destruction of the bony substance of the vertebra. Purulent and necrotic masses descend along the spine, forming a wandering abscess that may burst and create fistulas.
Tuberculous spondylitis develops slowly. At first, bone changes may be detected only through roentgenologic examination. The spread of the process to the tissues near the spine produces pain that intensifies with movement. Increasing spinal deformity is the most common cause of humpbacks. Paralyses, pain along the course of the nerves, and sensory disturbances may result from the compression of the spinal cord or the roots of spinal nerves by deformed vertebral bodies.
Spondylitis caused by a pyogenic infection may progress very rapidly, being characterized by high temperatures and intoxication. The destruction of vertebral bodies is less extensive with this form than with tuberculous spondylitis.
Tuberculous spondylitis is prevented and treated in the same manner as tuberculosis. Prolonged immobilization of the spine in a special plaster bed is effective in the early stage of the disease. The purulent and necrotic masses may be removed surgically. Immobilization, surgery, and antibiotics are used to treat other forms of spondylitis.
REFERENCESKrasnobaev, T. P. Kostno-sustavnoi tuberkulez u detei, 2nd ed. Moscow, 1950.
Chaklin, V. D. Ortopediia, books 1–2. Moscow, 1957.
Kornev, P. G. Klinika i lécheme kostno-sustavnogo tuberkuleza. Moscow, 1959.
Mnogotomnoe rukovodstvo po ortopedii i travmatologii, vol. 1. Moscow, 1967.