Department of Spine Surgery, The First Affiliated Hospital of Xinjiang Medical University, Ürümqi, 830054, Xinjiang, China.
Department of Trauma and Microreconstructive Surgery, The First Affiliated Hospital of Xinjiang Medical University, Ürümqi, 830054, Xinjiang, China.
BMC Surg. 2022 Apr 27;22(1):150. doi: 10.1186/s12893-022-01606-y.
To evaluate the efficacy of anterior debridement and bone grafting with fusion using internal fixation (BFIF) combined with anti-tuberculosis chemotherapy in the treatment of subaxial cervical spine tuberculosis (SCS-TB).
Clinical and radiographic data of patients with SCS-TB treated by anterior debridement and BFIF at our hospital from January 2010 to December 2017 were analyzed retrospectively. The SCS sagittal parameters at the preoperative, postoperative, and final follow-up were documented and compared, including the Occiput-C2 angle, C2-C7 Cobb angle, local Cobb angle, spinal canal angle (SCA), C2-C7 sagittal vertical axis (C2-C7 SVA), the center of gravity of the head-C7 sagittal vertical axis (CGH-C7 SVA), T1 slope (T1S), neck tilt (NT), and thoracic inlet angle (TIA). The ASIA grade, NDI index, JOA score, and VAS score were utilized to assess the postoperative function recovery, and the complications were recorded.
A total of 23 patients were included in the study with a mean age of 46.74 ± 15.43 years, including 8 males and 15 females. All patients with SCS-TB were treated with anterior debridement and BFIF, with a mean postoperative follow-up time of 37.17 ± 12.26 months. The poisoning symptoms of TB were relieved in all patients, and ESR (42.09 ± 9.53 vs 8.04 ± 5.41, P < 0.05) and CRP (30.37 ± 16.02 vs 7.4 ± 2.68, P < 0.05) were decreased at the 3 postoperative months in the comparison of the preoperative. The C0-C2 Cobb angle, C2-C7 Cobb angle, local Cobb angle, SCA, TIS, C2-C7 SVA, and CGH-C7 SVA were corrected remarkably after surgery (P < 0.05). Further, there was a significant improvement in the JOA, VAS, and NDI with the comparison of the preoperative (P < 0.05).
Anterior debridement and BFIF combined with anti-TB chemotherapy was a practical tool for the treatment of SCS-TB with the help of SCS sagittal parameters, which can remove the lesion completely, decompress the spinal cord compression, and correct the kyphotic deformity to restore the spine sagittal balance.
评估前路清创植骨融合内固定（BFIF）联合抗结核化疗治疗下颈椎结核（SCS-TB）的疗效。
回顾性分析 2010 年 1 月至 2017 年 12 月我院采用前路清创和 BFIF 治疗的 SCS-TB 患者的临床和影像学资料。记录并比较术前、术后和末次随访时 SCS 的矢状参数，包括枕骨-C2 角、C2-C7 Cobb 角、局部 Cobb 角、椎管角（SCA）、C2-C7 矢状垂直轴（C2-C7 SVA）、头-C7 矢状垂直轴重心（CGH-C7 SVA）、T1 斜率（T1S）、颈部倾斜（NT）和胸入口角（TIA）。采用 ASIA 分级、NDI 指数、JOA 评分和 VAS 评分评估术后功能恢复情况，并记录并发症。
本研究共纳入 23 例患者，平均年龄 46.74±15.43 岁，男性 8 例，女性 15 例。所有 SCS-TB 患者均采用前路清创和 BFIF 治疗，平均术后随访时间为 37.17±12.26 个月。所有患者的 TB 中毒症状均得到缓解，ESR（42.09±9.53 与 8.04±5.41，P<0.05）和 CRP（30.37±16.02 与 7.4±2.68，P<0.05）在术后 3 个月均降低。术后 C0-C2 Cobb 角、C2-C7 Cobb 角、局部 Cobb 角、SCA、TIS、C2-C7 SVA 和 CGH-C7 SVA 均显著矫正（P<0.05）。进一步，JOA、VAS 和 NDI 与术前相比均有显著改善（P<0.05）。
前路清创和 BFIF 联合抗结核化疗是治疗 SCS-TB 的一种实用方法，有助于 SCS 矢状参数的评估，可以彻底清除病灶、解除脊髓压迫、矫正后凸畸形，恢复脊柱矢状平衡。
