Wang Xi-Yang, Luo Cheng-Ke, Li Wei-Wei, Wu Ping, Pang Xiao-Yang, Xu Zheng-Quan, Zeng Hao, Peng Wei, Zhang Peng-Hui
Department of Spine Surgery, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
Eur J Trauma Emerg Surg. 2013 Feb;39(1):93-9. doi: 10.1007/s00068-012-0243-5. Epub 2013 Jan 19.
Cervical tuberculosis (CTB) is a relatively rare entity, even in endemic countries. Currently, management ranges from conservative to radical surgical approaches. We report our experience in diagnosing and treating 66 cases of CTB in the past eight years using our CTB therapeutic protocol.
All patients diagnosed with CTB were followed up over a 3.5-year period. Patients were divided into three grades using clinicoradiological criteria designed to evaluate the initial severity of the disease. Overall performance status was assessed based on the American Spinal Injury Association (ASIA) scale. Neurological recovery was evaluated with the ASIA scale as well as using X-rays and computed tomography every four weeks for the initial three months and every three months thereafter.
The mean follow-up duration was 38.2 ± 6.2 months. No mortality occurred. One case of recurrence due to irregular antitubercular treatment (ATT) was cured by abscess clearing and regular ATT. All other patients had good clinicoradiological outcomes, regardless of grading.
The use of our proposed scoring system and management protocol allowed speedy management of CTB.
即使在结核病流行国家,颈椎结核(CTB)也是一种相对罕见的病症。目前,其治疗方法从保守治疗到根治性手术治疗不等。我们报告了过去八年中使用我们的CTB治疗方案诊断和治疗66例CTB的经验。
所有诊断为CTB的患者均进行了3.5年的随访。根据旨在评估疾病初始严重程度的临床放射学标准,将患者分为三个等级。根据美国脊髓损伤协会(ASIA)量表评估总体功能状态。在最初的三个月内,每四周使用ASIA量表以及X射线和计算机断层扫描评估神经功能恢复情况,此后每三个月评估一次。
平均随访时间为38.2±6.2个月。无死亡病例。1例因抗结核治疗(ATT)不规律导致复发的患者,通过脓肿清除和规律的ATT治愈。所有其他患者,无论分级如何,均取得了良好的临床放射学结果。
使用我们提出的评分系统和管理方案能够快速管理CTB。