因骨髓炎导致的颈椎复杂 360°重建和稳定。
Complex 360°-reconstruction and stabilization of the cervical spine due to osteomyelitis.
机构信息
Department of Neurosurgery, Trauma Center Murnau, Prof.-Küntscher-Str. 8, 82418 Murnau, Germany.
出版信息
Eur Spine J. 2011 Jul;20 Suppl 2(Suppl 2):S248-52. doi: 10.1007/s00586-010-1645-x. Epub 2010 Dec 1.
Abstract
Osteomyelitis of the cervical spine may lead to profound bony destruction. The presented case developed multilevel osteomyelitic destruction of the cervical spine after decompression due to cervical myelopathy. He could be cured by a multiple-stage procedure: step one: debridement and removal of all anterior implants with vacuum-assisted closure combined with dorsal instrumentation from C0 to T3; step two: anterior reconstruction with expandable titanium cages and plate. The patient regained walking with the aid of a walking frame. The following recommendations are given: multiple stage procedure, extensive debridement and stabilization via an anterior and posterior approach, use of titanium implants.
摘要
颈椎骨髓炎可导致严重的骨质破坏。本例患者因颈椎病减压后发生多节段颈椎骨髓炎破坏。他通过多阶段手术得到治愈：第一步：清创和清除所有前路植入物，采用负压封闭引流联合后路 C0 至 T3 内固定；第二步：采用可扩张钛笼和钢板进行前路重建。患者借助助行器恢复行走。建议采用多阶段手术、通过前路和后路广泛清创和稳定、使用钛植入物。
相似文献
1
Complex 360°-reconstruction and stabilization of the cervical spine due to osteomyelitis.因骨髓炎导致的颈椎复杂 360°重建和稳定。
Eur Spine J. 2011 Jul;20 Suppl 2(Suppl 2):S248-52. doi: 10.1007/s00586-010-1645-x. Epub 2010 Dec 1.
2
Long segment spinal reconstruction of C3-T1 utilizing single strut fibula free flap following debridement and corpectomy for chronic osteomyelitis.采用单支柱腓骨游离皮瓣对慢性骨髓炎进行清创和椎体切除术，对 C3-T1 进行长节段脊柱重建。
Am J Otolaryngol. 2022 Mar-Apr;43(2):103310. doi: 10.1016/j.amjoto.2021.103310. Epub 2021 Dec 3.
3
Multilevel Corpectomy With Anterior Column Reconstruction and Plating for Subaxial Cervical Osteomyelitis.前路椎体次全切除、前柱重建及钢板固定治疗下颈椎骨髓炎
Spine (Phila Pa 1976). 2016 Sep 15;41(18):E1088-E1095. doi: 10.1097/BRS.0000000000001557.
4
Single-stage Treatment of Osteomyelitis of the Cervical Spine Using Anterior Instrumentation and Titanium Mesh Cages.采用前路内固定和钛网融合器一期治疗颈椎骨髓炎
Spine (Phila Pa 1976). 2016 Aug 15;41(16):E949-E954. doi: 10.1097/BRS.0000000000001515.
5
Reconstructive techniques study after anterior decompression of multilevel cervical spondylotic myelopathy.多节段脊髓型颈椎病前路减压术后重建技术的研究
J Spinal Disord Tech. 2009 Oct;22(7):511-5. doi: 10.1097/BSD.0b013e3181a6a1fa.
6
Posterior instrumentation, anterior column reconstruction with single posterior approach for treatment of pyogenic osteomyelitis of thoracic and lumbar spine.后路器械固定，单一后路入路行前柱重建治疗胸腰椎化脓性骨髓炎。
Eur Spine J. 2013 Mar;22(3):633-41. doi: 10.1007/s00586-012-2487-5. Epub 2012 Aug 25.
7
Pediatric cervical kyphosis in the MRI era (1984-2008) with long-term follow up: literature review.MRI 时代（1984-2008 年）的儿童颈椎后凸：文献回顾。
Childs Nerv Syst. 2022 Feb;38(2):361-377. doi: 10.1007/s00381-021-05409-z. Epub 2021 Nov 22.
8
Expandable titanium cages for anterior column cervical reconstruction and their effect on sagittal profile: a review of 48 cases.可扩张钛笼在前柱颈椎重建中的应用及其对矢状位的影响：48 例回顾性研究。
Acta Neurochir (Wien). 2013 May;155(5):801-7; discussion 807. doi: 10.1007/s00701-013-1655-7. Epub 2013 Mar 12.
9
Results of surgical treatment for degenerative cervical myelopathy: anterior cervical corpectomy and stabilization.退行性颈椎脊髓病的手术治疗结果：颈椎前路椎体次全切除及稳定术。
Spine (Phila Pa 1976). 2004 Nov 15;29(22):2493-500. doi: 10.1097/01.brs.0000145412.93407.c3.
10
Long-term biomechanical stability and clinical improvement after extended multilevel corpectomy and circumferential reconstruction of the cervical spine using titanium mesh cages.使用钛网笼进行颈椎广泛多节段椎体次全切除及环形重建后的长期生物力学稳定性及临床改善情况。
J Spinal Disord Tech. 2008 May;21(3):165-74. doi: 10.1097/BSD.0b013e3180654205.
引用本文的文献
1
Cervical osteomyelitis in the setting of multiple comorbidities: a complex anatomical approach. Illustrative case.多种合并症情况下的颈椎骨髓炎：一种复杂的解剖学方法。病例说明。
J Neurosurg Case Lessons. 2024 Oct 14;8(16). doi: 10.3171/CASE24448.
2
New classification for the treatment of pyogenic spondylodiscitis: validation study on a population of 250 patients with a follow-up of 2 years.化脓性脊椎椎间盘炎治疗的新分类：对250例患者进行2年随访的验证研究
Eur Spine J. 2017 Oct;26(Suppl 4):479-488. doi: 10.1007/s00586-017-5043-5. Epub 2017 Mar 21.
3
Cervical Spondylodiscitis After Oxygen-Ozone Therapy for Treatment of a Cervical Disc Herniation: a Case Report and Review of the Literature.氧-臭氧疗法治疗颈椎间盘突出症后发生颈椎化脓性椎间盘炎：1例病例报告及文献复习
HSS J. 2016 Oct;12(3):278-283. doi: 10.1007/s11420-016-9500-1. Epub 2016 Apr 18.
4
Cervical osteomyelitis with thoracic myelitis and meningitis in a diabetic patient.一名糖尿病患者并发颈椎骨髓炎、胸椎脊髓炎和脑膜炎。
Clin Med Insights Case Rep. 2015 May 12;8:37-40. doi: 10.4137/CCRep.S21678. eCollection 2015.
本文引用的文献
1
Beneficial influence of titanium mesh cage on infection healing and spinal reconstruction in hematogenous septic spondylitis: a retrospective analysis of surgical outcome of twenty-five consecutive cases and review of literature.钛网笼对血源性化脓性脊柱炎感染愈合及脊柱重建的有益影响：25例连续病例手术结果的回顾性分析及文献复习
Spine (Phila Pa 1976). 2008 Oct 1;33(21):E759-67. doi: 10.1097/BRS.0b013e318187875e.
2
Anterior debridement and fusion followed by posterior pedicle screw fixation in pyogenic spondylodiscitis: autologous iliac bone strut versus cage.化脓性脊椎椎间盘炎先行前路清创融合术，再行后路椎弓根螺钉内固定术：自体髂骨支撑植骨与椎间融合器的比较
J Neurosurg Spine. 2008 May;8(5):405-12. doi: 10.3171/SPI/2008/8/5/405.
3
Debridement and spinal instrumentation as a single-stage procedure in bacterial spondylitis/spondylodiscitis.清创术与脊柱内固定作为细菌性脊柱炎/椎间盘炎的一期手术。
Zentralbl Neurochir. 2007 Aug;68(3):123-32. doi: 10.1055/s-2007-984461. Epub 2007 Jul 30.
4
Treatment of vertebral osteomyelitis by radical debridement and stabilization using titanium mesh cages.使用钛网笼进行根治性清创和稳定术治疗椎体骨髓炎。
Spine (Phila Pa 1976). 2007 Apr 20;32(9):E275-80. doi: 10.1097/01.brs.0000261034.83395.7f.
5
[Surgical management of spondylodiscitis. An analysis of 78 cases].[脊椎椎间盘炎的外科治疗。78例分析]
Unfallchirurg. 2006 Sep;109(9):743-53. doi: 10.1007/s00113-006-1084-7.
6
Surgical treatment of spondylodiscitis in the cervical spine: a minimum 2-year follow-up.颈椎椎体椎间盘炎的外科治疗：至少2年的随访
Eur Spine J. 2006 Sep;15(9):1380-7. doi: 10.1007/s00586-006-0191-z. Epub 2006 Jul 26.
7
Anterior surgery with insertion of titanium mesh cage and posterior instrumented fusion performed sequentially on the same day under one anesthesia for septic spondylitis of thoracolumbar spine: is the use of titanium mesh cages safe?在同一麻醉下于同一天先后进行前路钛网笼植入及后路器械辅助融合术治疗胸腰椎化脓性脊柱炎：使用钛网笼安全吗？
Spine (Phila Pa 1976). 2006 Apr 20;31(9):1014-9. doi: 10.1097/01.brs.0000215049.08622.9d.
8
One-stage combined surgery with mesh cages for treatment of septic spondylitis.采用网笼进行一期联合手术治疗化脓性脊柱炎。
Clin Orthop Relat Res. 2006 Mar;444:51-9. doi: 10.1097/01.blo.0000203449.51769.7f.
9
[Surgical therapy of unspecific and specific Spondylodiscitis].[非特异性和特异性脊椎椎间盘炎的外科治疗]
Z Orthop Ihre Grenzgeb. 2005 Mar-Apr;143(2):204-12. doi: 10.1055/s-2005-836455.
10
Instrumentation in patients with spinal infection.脊柱感染患者的器械使用
Neurosurg Focus. 2004 Dec 15;17(6):E7. doi: 10.3171/foc.2004.17.6.7.
Zotero 插件