Saleh Ifran, Librianto Didik, Phedy Phedy, Efar Toto Suryo, Canintika Anissa Feby
Department of Orthopaedics & Traumatology, Cipto Mangunkusumo National Central Hospital, Jalan Diponegoro No. 71, Jakarta Pusat, 10430, Indonesia.
Department of Orthopaedics & Traumatology, Fatmawati General Hospital, Jalan RS Fatmawati No. 1, Cilandak Kota Jakarta Selatan, 12430, Indonesia.
Int J Surg Case Rep. 2020;69:109-113. doi: 10.1016/j.ijscr.2020.02.003. Epub 2020 Feb 6.
Cervicothoracic spinal tuberculosis (CTSTB) is a rare and disabling disease involving the mobile, transitional zone between the lordotic cervical and the kyphotic thoracic spine. Approximately half of those cases involves one or two segments of cervicothoracic vertebrae. We reported a 28-year-old female with tuberculous involvement of fourteen contiguous vertebral segments.
A 28-year-old female presented with tuberculous involvement of fourteen contiguous vertebral segments is presented. A series of radiographic and CT scan depicted multiple vertebral body destruction anteriorly, along with facet joint dislocation and mild retrolisthesis of C4-C5 segments. MR images of the cervical region was demonstrated pathologic contrast enhancement on C4 to T7 vertebrae, a total of fourteen contiguous segments.
Of all spinal tuberculosis, CTSTB accounts for only 5%. In addition to its rarity as a site for tuberculosis, the cervicothoracic junction has anatomical and clinical peculiarities, as a reversal of the mobile-lordotic cervical vertebrae to rigid-kyphotic thoracic vertebrae occurs at this location. Most CTSTB involves only two segments; however, in this case, we found a very extensive case wherein there were fourteen damaged segments.
Our report demonstrates one of the longest involvement of extensive contiguous CTSTB who was treated with one-stage posterior-only approach. However, as this is only a report of one case, further studies are required to investigate the safety and efficacy of such approach for treating extensive CTSTB.
颈胸段脊柱结核（CTSTB）是一种罕见且致残的疾病，累及颈椎前凸和胸椎后凸之间的活动过渡区。约半数病例累及一或两个颈胸段椎体。我们报告了一名28岁女性，其结核累及连续14个椎体节段。
本文介绍了一名28岁女性，其结核累及连续14个椎体节段。一系列X线和CT扫描显示多个椎体前部破坏，伴有小关节脱位及C4 - C5节段轻度椎体后移。颈椎MR图像显示C4至T7椎体，共14个连续节段有病理对比增强。
在所有脊柱结核中，CTSTB仅占5%。除作为结核发病部位较为罕见外，颈胸交界区具有解剖和临床特殊性，因为在此位置颈椎前凸活动节段转变为胸椎后凸僵硬节段。大多数CTSTB仅累及两个节段；然而，在本病例中，我们发现了一个非常广泛的病例，有14个受损节段。
我们的报告展示了采用一期单纯后路手术治疗的广泛连续CTSTB最长受累病例之一。然而，由于这只是一例报告，需要进一步研究来探讨这种方法治疗广泛CTSTB的安全性和有效性。
