Department of Orthopedics, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China; Medical Department of Graduate School, Nanchang University, Nanchang, China.
Department of Orthopedics, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China.
World Neurosurg. 2019 Jul;127:25-30. doi: 10.1016/j.wneu.2019.03.238. Epub 2019 Apr 1.
Cervical tuberculosis accounts for only 4.2%-12% of the total incidence of spinal tuberculosis cases. Although antituberculosis drugs have been the mainstay treatment of cervical tuberculosis, they have been ineffective against the symptoms of existing spinal deformities and spinal cord compression, which often require surgical intervention. The conventional surgical methods have been anterior debridement and titanium mesh, cage bone graft fusion and internal fixation. However, all have certain deficiencies regarding the stability of fixation.
We have presented the case of a 41-year-old Chinese man who had been experiencing neck pain and stiffness for 1 month. The symptoms had been accompanied by low-grade fever and repeated night sweats. The purified protein derivative test result was positive and the antituberculosis test result was negative. Imaging examination showed destruction of the C5 and C6 vertebral bodies and C5 andC6 intervertebral discs, with an intensive abscess at the C5-C6 vertebral level. After 3-dimensional printing-assisted anterior debridement and artificial vertebral body replacement, his preoperative symptoms of neck pain and stiffness had been alleviated. Also, his symptoms of numbness in both upper limbs had disappeared completely. At the last follow-up examination, he had recovered well and the tuberculosis focus had been completely cured.
To the best of our knowledge, we have reported the first clinical application of 3-dimensional printing-assisted cervical anterior bilateral pedicle screw fixation of an artificial vertebral body. We accomplished ultrashort segment fixation, with excellent clinical outcomes obtained, which were maintained at the recent 2-year follow-up examination.
颈椎结核仅占脊柱结核总发病率的 4.2%-12%。虽然抗结核药物一直是治疗颈椎结核的主要方法，但对于现有的脊柱畸形和脊髓压迫症状无效，往往需要手术干预。传统的手术方法是前路清创和钛网、笼骨植骨融合内固定。然而，所有这些方法在固定的稳定性方面都存在一定的缺陷。
我们报告了一例 41 岁的中国男性，他有 1 个月的颈部疼痛和僵硬的病史。症状伴有低热和反复夜间出汗。结核菌素纯蛋白衍生物试验结果阳性，抗结核试验结果阴性。影像学检查显示 C5 和 C6 椎体及 C5 和 C6 椎间盘破坏，C5-C6 椎体水平有密集脓肿。在 3D 打印辅助前路清创和人工椎体置换后，他的颈部疼痛和僵硬的术前症状得到缓解。同时，他的双上肢麻木症状也完全消失。在最后一次随访检查时，他恢复良好，结核病灶已完全治愈。
据我们所知，我们首次报告了 3D 打印辅助颈椎前路双侧椎弓根螺钉固定人工椎体的临床应用。我们完成了超短节段固定，获得了良好的临床效果，在最近的 2 年随访中得到了维持。
