What are the typical symptoms of lumbar tuberculosis?

The most common symptom of lumbar spine tuberculosis is low back pain. The nature of the pain is mainly dull or aching, accompanied by tenderness and percussion pain. The pain intensifies with fatigue, coughing, and before sleep. Upper lumbar spine tuberculosis can cause pain in the thighs, while lower lumbar spine tuberculosis can cause sciatica. This is due to tuberculous abscesses, granulation tissue, and necrotic intervertebral discs or dead bone protruding backward into the vertebral canal. When the spinal cord or nerve roots are compressed or stimulated, radiating pain can occur. The specific manifestations are as follows:

1. Pain: In the early stages, local pain is not obvious. Adjacent nerve roots are stimulated or compressed, such as intercostal neuralgia in thoracic spine tuberculosis; lumbar spine tuberculosis stimulates or compresses the lumbar plexus nerves causing low back and leg pain; when simple bone tuberculosis or synovial tuberculosis develops into full-joint tuberculosis, the pain intensifies, often drawing the patient's attention. To relieve pain, the muscles at the affected site remain in a spasm state for protection. When the patient's position changes, especially during nighttime sleep, the pain is more pronounced, and children often cry at night.

2. Dysfunction: Usually, joint dysfunction occurs earlier than pain in patients. To relieve pain, each joint is often forced into special positions such as shoulder joint drooping, elbow joint semi-flexion, hip joint flexion, and ankle joint foot droop. Cervical spine tuberculosis often involves supporting the mandible with both hands, while muscle protective spasms in patients with thoracic or lumbar spine tuberculosis lead to difficulty bending and careful squatting to pick up objects.

3. Swelling: Local swelling in tuberculosis of the limbs' joints is easy to detect, with normal skin color, and a locally warm sensation. Joint swelling gradually increases, limb muscles atrophy, and the affected joint takes a spindle shape.

4. Deformity: As the lesion progresses or spinal bone damage develops, the aforementioned unique postures remain unchanged. Further development leads to further limited joint mobility, and spinal tuberculosis mostly presents with angular kyphosis deformity.