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[儿童脊柱结核的治疗。关于100例病例]

[The treatment of Pott's disease in children. Apropos of 100 cases].

作者信息

Harouchi A, Padovani J P, Refass A, el Andaloussi M, Fehri M

出版信息

Chir Pediatr. 1985;26(3):123-32.

PMID:4064228
Abstract

Between 1976 and 1984, 100 children aged 13 months to 15 years were treated for tuberculosis of the spine. 29 patients seen at an early stage and presenting limited lesions healed completely with mild or moderate residual kyphosis after orthopaedic treatment associating antibiotherapy and strict immobilization in plaster shells. 71 patients having extensive vertebral destruction or after failure of the orthopaedic treatment underwent surgery for excision and anterior spine fusion. A supplementary posterior spine fusion was performed in 48 patients. This procedure, in conjunction with preoperative traction, obtained stabilization of the spine and healing of vertebral lesions in most cases with excellent correction of recent kyphosis. In view of these results, it seems possible to determine which treatment is best adapted according to: the extent, severity and level of the lesions, the degree and age of kyphosis, the existence or not of paraplegia. The possibility to reduce fixed severe kyphosis (6 cases) and the indication for a supplementary posterior fusion are evaluated.

摘要

1976年至1984年间,100名年龄在13个月至15岁的儿童接受了脊柱结核治疗。29例早期就诊且病变局限的患者,在接受骨科治疗(联合抗生物治疗及严格的石膏固定)后完全愈合,遗留轻度或中度脊柱后凸。71例椎体广泛破坏或骨科治疗失败的患者接受了手术切除及前路脊柱融合术。48例患者进行了补充后路脊柱融合术。该手术结合术前牵引,在大多数情况下实现了脊柱稳定和椎体病变愈合,近期脊柱后凸得到了良好矫正。鉴于这些结果,似乎可以根据以下因素确定哪种治疗方法最适合:病变的范围、严重程度和部位、脊柱后凸的程度和年龄、是否存在截瘫。评估了减轻固定性严重脊柱后凸(6例)的可能性以及补充后路融合术的适应证。

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