Mutoh Manabu, Fukuoka Toshiki, Suzuki Osamu, Hattori Shinnosuke
Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, JPN.
Department of Neurosurgery, Nagoya Ekisaikai Hospital, Nagoya, JPN.
Cureus. 2021 Sep 5;13(9):e17747. doi: 10.7759/cureus.17747. eCollection 2021 Sep.
Cervical pyogenic spondylodiscitis is rare but can lead to severe clinical problems that often require aggressive surgical treatment for neurological deterioration and life-threatening conditions. Although combined surgical procedures are often utilized to treat multilevel cervical regions, there is a clinical debate regarding the appropriate order and timing of surgeries using the anterior and posterior approaches. Here, we report a case of severe multilevel cervical pyogenic spondylodiscitis treated using a three-staged surgical strategy consisting of cervical laminectomy, posterior fixation, and anterior corpectomy and fusion with an autologous long bone graft; the outcome was quite favorable. Our report demonstrates the safety and usefulness of three-staged surgery in the multilevel cervical region, especially under urgent situations.
颈椎化脓性椎间盘炎较为罕见,但可导致严重的临床问题,常因神经功能恶化和危及生命的情况而需要积极的手术治疗。尽管联合手术常被用于治疗多节段颈椎区域,但对于采用前路和后路手术的合适顺序和时机存在临床争议。在此,我们报告一例严重的多节段颈椎化脓性椎间盘炎病例,采用了包括颈椎椎板切除术、后路固定、前路椎体次全切除及自体长骨移植融合的三阶段手术策略进行治疗;结果相当良好。我们的报告证明了三阶段手术在多节段颈椎区域的安全性和有效性,尤其是在紧急情况下。