Cavus Gokhan, Gezercan Yurdal, Ökten Ali Ihsan, Tolunay Orkun, Çelik Tamer, Arslan Ali, Çelik Ümit
Department of Neurosurgery, Adana Numune Training and Research Hospital, Serinevler Mah, Ege Bağatur Bulvarı, 01260, Yüreğir, Adana, Turkey.
Department of Pediatrics, Adana Numune Training and Research Hospital, Yüreğir, Adana, Turkey.
Childs Nerv Syst. 2018 Jun;34(6):1221-1227. doi: 10.1007/s00381-017-3678-5. Epub 2017 Dec 16.
Tuberculosis is a common disease worldwide that is caused by Mycobacterium tuberculosis. Tuberculosis is primarily a pulmonary disease, but extrapulmonary manifestations are not uncommon, especially in children and adolescents.
We present two pediatric patients who underwent surgery in our clinic for Pott's disease in the upper thoracic region. The patients were investigated to describe their age, complaints, neurological examination results, disease location, surgical procedure, and complications.
The patients were 2 and 14 years old and exhibited disease located in the upper thoracic region (T2-T3 and T1-T2). Both patients displayed severe neurological deficits (Frankel B and C). The kyphotic angles were 82.2° and 43.2°. The patients were stabilized by applying fusion using transpedicular screws via a posterior approach. They also underwent anti-tuberculosis treatment for approximately 1 year. One year later, neither patient exhibited any neurological deficit, and their kyphotic angles were measured as 11° and 1°, respectively.
The recommended treatment approach for unstable cases of Pott's disease located in the upper thoracic region who exhibit neurological deficit and severe kyphotic angling or the development of kyphosis on the thoracic vertebrae is surgical. Decompression, stabilization, and fusion and kyphotic correction can be safely performed via a posterior approach. One of the present cases is the youngest patient described in the literature to undergo transpedicular surgery as a result of Pott's disease. Our other case is the first described in the literature who developed ptosis as a result of tuberculosis and underwent a procedure via posterior transpedicular screw.
结核病是一种全球常见疾病，由结核分枝杆菌引起。结核病主要是一种肺部疾病，但肺外表现并不罕见，尤其是在儿童和青少年中。
我们介绍了两名在我们诊所接受上胸椎结核手术的儿科患者。对患者进行调查以描述他们的年龄、主诉、神经学检查结果、疾病部位、手术过程和并发症。
患者分别为2岁和14岁，病变位于上胸椎区域（T2 - T3和T1 - T2）。两名患者均表现出严重的神经功能缺损（Frankel B级和C级）。后凸角分别为82.2°和43.2°。通过后路经椎弓根螺钉固定融合使患者病情稳定。他们还接受了约1年的抗结核治疗。一年后,两名患者均未出现任何神经功能缺损，后凸角分别测量为11°和1°。
对于位于上胸椎区域、表现出神经功能缺损以及严重后凸角或胸椎后凸畸形发展的不稳定结核病例，推荐的治疗方法是手术。通过后路可以安全地进行减压、稳定、融合和后凸矫正。本病例中的一名患者是文献中描述的因结核接受经椎弓根手术的最年轻患者。我们的另一例是文献中首次描述的因结核导致上睑下垂并通过后路经椎弓根螺钉进行手术的病例。
