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17岁颈椎结核性脊柱炎伴四肢轻瘫患者的成功手术治疗:病例报告

Successful surgical management of cervical tuberculous spondylitis with tetraparesis in a 17-year-old patient: A case report.

作者信息

Ekasari Septika, Sugianto Paulus, Setyowatie Sita

机构信息

Department of Neurology, Dr Soetomo General Academic Hospital, Surabaya, Indonesia.

Department of Neurology, Faculty of Medicine, Airlangga University, Surabaya, Indonesia.

出版信息

Radiol Case Rep. 2024 Nov 29;20(2):1099-1104. doi: 10.1016/j.radcr.2024.11.037. eCollection 2025 Feb.

Abstract

Cervical tuberculous spondylitis is a rare and potentially life-threatening manifestation of spinal tuberculosis, accounting for only 3%-5% of all cases of spinal tuberculosis This report describes a case of a 17-year-old male patient who developed tetraparesis 2 weeks prior to hospital admission, after a 6-month record of progressive neck pain. Magnetic Resonance Imaging revealed tuberculous spondylodiscitis involving multiple vertebrae, with a severe spinal cord compression at C2-C3 due to an intraosseous abscess and paravertebral soft tissue mass. The patient underwent anterior cervical corpectomy and fusion at C3 with autologous iliac bone graft and anterior stabilization. Post-operatively, he received anti-tuberculosis drug regimen for 12 months and followed a structured rehabilitation program. The patient's motor function improved from 2/5 to 5/5, with full recovery within 12 months post-operatively. This case emphasizes the significance of early diagnosis, comprehensive radiological evaluation, and timely surgical intervention in managing cervical tuberculous spondylitis with neurologic deficits.

摘要

颈椎结核性脊柱炎是脊柱结核一种罕见且可能危及生命的表现形式,仅占所有脊柱结核病例的3%-5%。本报告描述了一名17岁男性患者,在经历6个月渐进性颈部疼痛后,入院前2周出现四肢瘫痪。磁共振成像显示结核性脊椎间盘炎累及多个椎体,由于骨内脓肿和椎旁软组织肿块,在C2-C3处出现严重脊髓压迫。患者接受了C3前路椎体次全切除、自体髂骨移植融合及前路内固定术。术后,他接受了12个月的抗结核药物治疗方案,并遵循了结构化康复计划。患者的运动功能从2/5改善至5/5,术后12个月内完全恢复。该病例强调了早期诊断、全面影像学评估以及及时手术干预在治疗伴有神经功能缺损的颈椎结核性脊柱炎中的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7b3/11647121/aeb2c50abd00/gr1.jpg

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