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上颈椎结核性脊柱炎所致的不稳定治疗

Instability treatment due to upper cervical tuberculous spondylitis.

作者信息

Lumban Tobing Singkat Dohar Apul, Irawan Rendra, Triadi Wijaya Mohammad, Antoro Aji, Setiawan Eko, Septian Rian

机构信息

Spine Division, Department of Orthopaedic & Traumatology, Cipto Mangunkusumo National Central Hospital and Faculty of Medicine, Universitas Indonesia, Jalan Diponegoro No. 71, Central Jakarta, Jakarta 10430, Indonesia.

Department of Orthopaedic & Traumatology, Cipto Mangunkusumo National Central Hospital and Faculty of Medicine, Universitas Indonesia, Jalan Diponegoro No. 71, Central Jakarta, Jakarta 10430, Indonesia.

出版信息

Int J Surg Case Rep. 2019;61:267-270. doi: 10.1016/j.ijscr.2019.07.044. Epub 2019 Jul 23.

Abstract

INTRODUCTION

Upper Cervical Spondylitis is a rare case, approximately 0.3-1% of all Tuberculous Spondylitis. Nevertheless, it causes destruction and morbidity more than Tuberculous Spondylitis at other side. Instability at upper cervical make patient cannot perform loadbearing activity. Treatments consist of anterior debridement with fusion and posterior stabilization is one of treatment that present good outcome. This study has been reported in line with the SCARE criteria (Fang et al., 1983) [1].

MATERIAL AND METHOD

We collected the data A 22 years old young man with chief complaint of severe pain on his neck since 1 year before admission. And this work has been reported in line with the SCARE criteria. He was diagnosed Tuberculous Spondylitis at C1-C2 and C6-C7 and got debridement, decompression and posterior stabilization and fusion also with occipital plate, lateral mass and long rods.

RESULT

Performing debridement, decompression, posterior stabilization and fusion using occipital plate, lateral mass and rods as a treatment for Upper Cervical Tuberculous Spondylitis give promising outcome. For increasing functional outcome, patient got sensoric and motoric exercise by physiotherapy CONCLUSION: Upper cervical treatment with debridement, decompression, posterior stabilization and fusion using occipital plate, lateral mass and rods give optimal outcome.

摘要

引言

上颈椎结核是一种罕见病例,约占所有脊柱结核的0.3 - 1%。然而,它比其他部位的脊柱结核造成的破坏和发病率更高。上颈椎不稳定使患者无法进行负重活动。治疗方法包括前路清创融合和后路稳定术,后路稳定术是一种效果良好的治疗方法。本研究已按照SCARE标准(Fang等人,1983年)[1]进行报告。

材料与方法

我们收集了一名22岁男性的数据,该患者自入院前1年起主要抱怨颈部剧痛。并且这项工作已按照SCARE标准进行报告。他被诊断为C1 - C2和C6 - C7椎体结核,并接受了清创、减压以及后路稳定融合术,同时使用了枕骨板、侧块和长杆。

结果

采用枕骨板、侧块和长杆进行清创、减压、后路稳定融合术治疗上颈椎结核取得了良好的效果。为了提高功能恢复效果,患者通过物理治疗进行了感觉和运动锻炼。结论:采用枕骨板、侧块和长杆进行上颈椎清创、减压、后路稳定融合术可获得最佳效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/714b/6698776/063f51ba831a/gr1.jpg

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