Lumbar spine tuberculosis, a member of the bone tuberculosis disease family, has a high incidence and is the first of the systemic bone and joint tuberculosis. Patients with lumbar spine tuberculosis mostly have loss of appetite, emaciation, anemia or hypoproteinemia, and should be actively supplemented with tasty, easily digestible, nutritious food. Lumbar spine tuberculosis is mostly seen in adults, and the lesions are confined to the upper and lower edges of the vertebral body and soon invade the intervertebral discs and adjacent vertebral bodies. Intervertebral disc destruction is characteristic of the disease, resulting in a narrow vertebral space. Most lumbar spine tuberculosis is caused by pulmonary tuberculosis, and the tubercle bacilli are transmitted to the bone tissue with the blood stream. A few tubercle bacilli evade anti-tuberculosis drugs and hide in the body, colonizing the infection when the body’s immunity decreases, causing bone destruction to develop into bone tuberculosis. The vertebral body of the spine is dominated by cancellous bone, and its trophoblastic artery is the terminal artery, where the venous blood flows slowly, making it easy for the tuberculosis bacilli to stay in the vertebral area. Clinical manifestations The common symptoms can be divided into two categories: local symptoms and systemic symptoms. Local symptoms 1. Pain Lumbar pain is the most common symptom of lumbar spinal tuberculosis. Dull pain in the affected area is often present simultaneously with systemic symptoms such as low fever, accompanied by pressure pain and percussion pain, aggravated by activity, coughing and sneezing, and relieved by bed rest; the pain is aggravated at night. The pain may radiate along the spinal nerve and the thoracic spine along the intercostal nerve to the abdomen, and is often misdiagnosed as cholecystitis, pancreatitis, appendicitis, etc. Lumbar spine lesions along the lumbar plexus mostly radiate to the front of the thigh, occasionally involving the back of the leg, and are easily misdiagnosed as intervertebral disc prolapse. The pain is more obvious when the patient changes position, especially at night when sleeping and losing the protection of muscle spasm. 2. Postural abnormalities are caused by spasm of the paravertebral muscles due to pain. Patients with cervical tuberculosis often have sloping neck, forward head tilt, shortened neck and hands holding the jaw. The posture of chest and abdomen is common in the thoracolumbar or lumbosacral spine structure. Normal people can bend over to pick up things, but because of the disease can not bend over but bend the hip and knee, one hand on the knee and the other hand to pick up things on the ground, called a positive pick-up test. 3, spinal deformity From top to bottom, look for abnormal protrusion of each spinous process especially limited angular posterior protrusion, and young vertebral epiphyseal chondromalacia, ankylosing spondylitis, poor posture, etc. into arcuate posterior protrusion and round back is different. 4.Chill abscess 70% to 80% of the time of consultation is complicated by a cold abscess, located in the depth of the spinal paravertebral abscess can be revealed by X-ray radiography CT or MRI. Systemic symptoms The disease starts gradually and the date of onset is not clear. Patients have generalized toxic symptoms such as lethargy and weakness, loss of appetite, low fever in the afternoon, night sweats and emaciation. Occasionally, a small number of acute episodes of deterioration with a temperature of about 39℃ are seen, which are mostly misdiagnosed as severe colds or other acute infections. Imaging examinations X-ray film shows mainly bone destruction and spinal space narrowing. It can show irregular bone destruction, narrowing or disappearance of the vertebral space, collapse of the vertebral body, cavity, dead bone and cold abscess shadow and other signs. CT examination can clearly show the site of the lesion, with or without cavity and dead bone formation. Even small paravertebral abscesses can be detected when examined on CT. MRI has early diagnostic value and can show abnormal signals at the stage of inflammatory infiltration, but it is mainly used to observe whether there is compression and degeneration of the spinal cord. Lumbar spine tuberculosis is not a simple inflammation, it is a lesion formed by the tuberculosis bacillus eroding the lumbar spine. If you have the above symptoms, seek early medical attention to avoid delaying the disease.