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颈椎前路椎间盘切除融合术后相邻节段继发性结核:一例报告。

Secondary tuberculosis of adjacent segments after anterior cervical discectomy and fusion: A case report.

作者信息

Liu Chengjiang, Liu Yidong, Ma Boyuan, Zhou Mengmeng, Zhao Xinyan, Fu Xuanhao, Kan Shunli, Hu Wei, Zhu Rusen

机构信息

Department of Spine Surgery, Tianjin Union Medical Center, Tianjin, China.

出版信息

Front Surg. 2023 Jan 6;9:1077353. doi: 10.3389/fsurg.2022.1077353. eCollection 2022.

Abstract

INTRODUCTION

Anterior cervical discectomy and fusion (ACDF) is a common operation for spinal surgery to treat a variety of cervical diseases. The postoperative infection rate of this procedure is extremely low, and adjacent segments are rarely involved. Tuberculosis (TB) is a common infectious disease that affects the spine in less than 1% of cases and is more common in the thoracolumbar and rarely cervical spine. Herein, for the first time, we report tuberculosis infection in adjacent segments after ACDF.

CASE PRESENTATION

We report a 50-year-old patient with cervical spondylotic myelopathy (CSM) who was discharged from the hospital after receiving ACDF at the C3/4 level. Two months later, he was admitted to the hospital with neck pain and found to be infected with tuberculosis in C4/5. After 4 months of anti-tuberculosis treatment, the vertebral body was fused.

CONCLUSION

After ACDF, the adjacent cervical vertebrae were infected with TB but the infection was limited. We believe that the special vertebral blood supply and postoperative secondary blood-borne infection may lead to the occurrence of extrapulmonary tuberculosis.

摘要

引言

颈椎前路椎间盘切除融合术(ACDF)是脊柱外科治疗多种颈椎疾病的常见手术。该手术的术后感染率极低,相邻节段很少受累。结核病(TB)是一种常见的传染病,累及脊柱的病例不到1%,在胸腰椎更为常见,颈椎则很少见。在此,我们首次报告了ACDF术后相邻节段的结核感染。

病例报告

我们报告一名50岁的脊髓型颈椎病(CSM)患者,在C3/4节段接受ACDF后出院。两个月后,他因颈部疼痛入院,发现C4/5节段感染结核。经过4个月的抗结核治疗,椎体融合。

结论

ACDF术后,相邻颈椎感染结核,但感染局限。我们认为,特殊的椎体血供和术后继发性血行感染可能导致肺外结核的发生。

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