寰枢椎脱位的颅颈交界区结核的外科治疗——一例病例报告及文献复习
Surgical management of craniocervical junction tuberculosis with atlanto-axial dislocation - A case report and review of the literature.
作者信息
Amin Md Rezaul, Rahman Md Tauhidur, Hossain A B M Manwar, Quader Tahsina, Islam Km Tarikul
机构信息
Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
出版信息
Surg Neurol Int. 2023 Oct 6;14:359. doi: 10.25259/SNI_731_2023. eCollection 2023.
BACKGROUND
There are few guidelines on how to best manage craniovertebral junction (CVJ) tuberculosis (TB). Certainly, timely tissue diagnosis, immobilization of the neck, and decompression of CVJ with appropriate stabilization are the mainstays of treatment for TB at the CVJ.
CASE DESCRIPTION
Three patients, ages 16-68, presented with CVJ TB with atlanto-axial dislocation responsible for progressive quadriparesis/plegia. Based on X-rays, magnetic resonance, and computed tomography studies, patients underwent timely decompressions and fusions followed by antitubercular drug treatment.
CONCLUSION
Early diagnosis, proper decompression with fusion, treated with anti-TB drug for proper period were keys to managing TB involving the craniocervical junction in these three patients.
背景
关于如何最佳管理颅颈交界区（CVJ）结核（TB）的指南很少。当然，及时的组织诊断、颈部固定以及对CVJ进行适当稳定的减压是CVJ结核治疗的主要方法。
病例描述
三名年龄在16 - 68岁的患者，表现为CVJ结核并伴有寰枢椎脱位，导致进行性四肢瘫/偏瘫。基于X线、磁共振成像和计算机断层扫描研究，患者接受了及时的减压和融合手术，随后进行抗结核药物治疗。
结论
早期诊断、适当的减压融合以及在适当时间使用抗结核药物治疗是这三名患者管理涉及颅颈交界区结核的关键。
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