Tarantino R, Donnarumma P, Fazzolari B, Marruzzo D, Delfini R
Department of Neurological Sciences, Neurosurgery, University Sapienza of Rome, Italy.
Clin Ter. 2013;164(2):97-100. doi: 10.7417/CT.2013.1525.
To evaluate the best treatment of Pott's disease.
7 cases of Pott's disease were treated in the department of Neurosurgery of Sapienza University of Rome (Italy) between 2004 to 2011.
All patients underwent surgical drainage of abscess and vertebral stabilization. In all cases culture exam showed positivity after 40 days of incubation. After surgery for a period of one year chemotherapy was administered. In all cases MRI scan with gd of the spinal column were performed 12 months after surgery and no recurrence of disease has been shown.
Pott's disease is defined as vertebral involvement of extrapulmonary Tubercolosis (TB), involving mainly toraco-lumbar tract of the spine. MRI with gd represents the gold standard for the diagnosis. Treatment can be medical, surgical or usually both. The slippery course of the disease often causes a delay in getting to a diagnosis that is not made prior to rising signs, such as large abscess, neurological impairment or vertebral fractures. In these cases medical treatment alone did not show effective results, because no specific antibiotic drug can permeate the abscess's capsule, and an effective concentration is not achieved in the infection's site. Therefore, surgical treatment is necessary to abscess draining and setting the correct medical treatment to mycobacterial eradication.
评估脊柱结核的最佳治疗方法。
2004年至2011年期间，意大利罗马第二大学神经外科治疗了7例脊柱结核患者。
所有患者均接受了脓肿手术引流和椎体固定。所有病例培养检查在孵育40天后显示阳性。术后一年内进行化疗。所有病例在术后12个月进行了脊柱钆增强磁共振成像扫描，未显示疾病复发。
脊柱结核被定义为肺外结核（TB）累及椎体，主要累及脊柱胸腰段。钆增强磁共振成像为诊断的金标准。治疗方法可以是药物治疗、手术治疗或通常两者结合。该病病程易变，常常导致诊断延迟，在出现诸如大脓肿、神经功能损害或椎体骨折等体征之前无法做出诊断。在这些情况下，单纯药物治疗未显示出有效结果，因为没有特定的抗生素药物能够渗透脓肿包膜，无法在感染部位达到有效浓度。因此，手术治疗对于脓肿引流以及为根除分枝杆菌确定正确的药物治疗是必要的。
