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三阶段手术策略作为多节段颈椎化脓性椎间盘炎的联合治疗方法

Three-Staged Surgical Strategy as a Combined Approach for Multilevel Cervical Pyogenic Spondylodiscitis.

作者信息

Mutoh Manabu, Fukuoka Toshiki, Suzuki Osamu, Hattori Shinnosuke

机构信息

Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, JPN.

Department of Neurosurgery, Nagoya Ekisaikai Hospital, Nagoya, JPN.

出版信息

Cureus. 2021 Sep 5;13(9):e17747. doi: 10.7759/cureus.17747. eCollection 2021 Sep.

Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84dd/8493043/f58f98aeb345/cureus-0013-00000017747-i01.jpg

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