Stepwise Therapy for Treating Tuberculosis of the Upper Cervical Spine: A Retrospective Study of 11 Patients
| Autor: | Songhua Xiao, Ning Lu, Lin Zhang, Kedong Hou, Huadong Yang, Xifeng Zhang |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Percutaneous Tuberculosis medicine.medical_treatment Antitubercular Agents Spinal cord compression medicine Humans Retrospective Studies business.industry Retropharyngeal abscess Retrospective cohort study medicine.disease Surgery Catheter Spinal Fusion medicine.anatomical_structure Neurology Spinal fusion Cervical Vertebrae Female Spinal Diseases Neurology (clinical) business Cervical vertebrae |
| Zdroj: | European Neurology. 74:100-106 |
| ISSN: | 1421-9913 0014-3022 |
| Popis: | Aims: Tuberculosis of the upper cervical spine is a rare occurrence with serious consequence, and its optimal treatment protocol remains inconclusive. This study aims at investigating the clinical characteristics and management outcomes of the stepwise therapy for different stages of tuberculosis of the upper cervical spine. Methods: We conducted a retrospective analysis of 11 patients with tuberculosis of the upper cervical spine who received anti-tuberculosis chemotherapy for 15 months. Two infants were treated by individualized chemotherapy, while 9 patients with retropharyngeal abscess were first treated with CT-guided percutaneous puncture, and the catheter was used to administer local chemotherapy. Two of these 9 patients continued to receive posterior instrumentation due to atlantoaxial subluxation. Patients were followed up clinically and radiologically for an average period of 60 months. Results: Two patients underwent catheter change due to catheter falling off and blockage, 2 patients had gastrointestinal side effects, and 2 patients had drug-induced hepatitis derived from the chemotherapy. Mean erythrocyte sedimentation rate was 10.27 mm/h (range 4-16 mm/h) and average visual analogue scale score was 2.55. A total of 11 cases underwent routine anti-tuberculosis chemotherapy for 15 months. 9 of 11 cases received supplementary surgical therapy, and all patients were cured at the final follow-up. Conclusion: Standard anti-tuberculosis chemotherapy is the cornerstone of stepwise therapy for tuberculosis of the upper cervical spine. Local chemotherapy is effective and minimally invasive for patients with severe local symptoms without spinal cord compression. Just as in patients with atlantoaxial instability, open fixation and bone grafting are necessary. |
| Databáze: | OpenAIRE |
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