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[颈椎结核的前路手术治疗。附7例报告]

[Anterior approach of cervical spine in Pott's disease. Apropos of 7 cases].

作者信息

Achouri M, Hilmani S, Lakhdar H, Ait Ben Ali S, Naja A, Ouboukhlik A, el Kamar A, el Azhari A, Boucetta M

机构信息

Service de Neurochirurgie, CHU Ibn Rochd, Casablanca, Maroc.

出版信息

Rev Chir Orthop Reparatrice Appar Mot. 1997;83(5):447-53.

PMID:9452797
Abstract

This study reports 7 cases of cervical Pott's disease, gathered during 6 years in the department of neuro-surgery of Ibn Rochd U.H.C. 4 females and 3 males, aged between 9 and 52 years were included. All the patients complained of cervicobrachial pain and weakness of the limbs. Clinical features were: deterioration of general status, rachidian syndrome and neurological impairement with motor and sensitive deficit. Radiological analysis found a destructive and extensive lesion, cervical kyphosis from 10 degrees to 60 degrees, retropharyngeal abscess and intraspinal canal extension of infection. Diagnosis was confirmed by histological study in all cases. In addition to antituberculous therapy and preoperative cervical traction in 4 cases, all the patients had spinal fusion using an anterior approach. Post operative immobilization in a cervical collar varied from 9 to 12 months. All 7 patients had full neurological recovery, 6 patients had an excellent bony fusion and cervical kyphosis was corrected. For the remaining patient, the bone graft was mobilized without neurological disorders. This study confirms anterior arthrodesis efficiency. This procedure in conjunction with preoperative traction, allowed stabilization of the spine and healing of vertebral lesions with excellent kyphosis correction.

摘要

本研究报告了伊本·罗什德大学医院神经外科在6年期间收集的7例颈椎结核病例。纳入了4名女性和3名男性,年龄在9岁至52岁之间。所有患者均主诉颈臂疼痛和肢体无力。临床特征为:全身状况恶化、脊柱综合征以及伴有运动和感觉功能缺损的神经功能损害。放射学分析发现有破坏性的广泛病变、颈椎后凸10度至60度、咽后脓肿以及感染向椎管内蔓延。所有病例均通过组织学研究得以确诊。除4例患者进行抗结核治疗和术前颈椎牵引外,所有患者均采用前路进行脊柱融合术。术后使用颈托固定9至12个月。所有7例患者神经功能均完全恢复,6例患者获得了良好的骨融合,颈椎后凸得到矫正。对于其余1例患者,骨移植未出现神经功能障碍。本研究证实了前路关节融合术的有效性。该手术结合术前牵引,实现了脊柱的稳定以及椎体病变的愈合,并出色地矫正了后凸畸形。

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