摘要
目的探讨局部化疗治疗颈椎结核的方法和临床疗效。方法回顾性分析2002年7月～2010年8月局部化疗治疗颈椎结核患者21例。在治疗过程中4例因为病情控制不佳改为开放手术,最终有17例患者接受了单纯局部化疗。其中1例颈胸腰结核患者有脊髓压迫症状,为Frankel C级,其余患者感觉运动正常。11例患者为双椎体结核,4例为3个椎体结核,2例为4个椎体及以上脊柱结核。1例有病灶附近节段骨折内固定病史,1例有病灶开放引流病史。结果本组病例随访14个月～5年,平均3年。随访显示临床症状完全消失,实验室检查正常,影像学检查示所有结核病灶愈合,上颈椎生理弯曲正常,下颈椎3例病灶愈合后末次随访后凸角度增加,分别至10°、18°和25°。均没有行二期矫正手术。1例Frankel C级患者恢复到E级。随访时无窦道形成、无假关节形成,末次随访无复发。结论局部化疗是颈椎结核的有效治疗方法之一,上颈椎结核痊愈后没有明显后凸畸形,下颈椎结核痊愈后部分患者会有不同程度的后凸畸形。
Objective To investigate the clinical efficacy of local chemotherapy for cervical tuberculosis.Methods From July 2002 to August 2010,21 patients with cervical tuberculosis were treated by local chemotherapy.In the course of treatment,4 patients had to undergo an operation because of poor disease control,and 17 patients received local chemotherapy alone.One patient who suffered at cervical,thoracal and lumbar segament had spinal cord compression sysmptom with classification of Frankel C.The feeling and movement were normal in the remaining patients.There were 2 affected vertebrae in 11 cases,3 affected vertebrae in 4 cases,4 or more affected vertebrae in 2 cases.One patient had a history of fracture fixation near to the infected segments.And another had a history of open drainage.Results The duration of mean follow-up was 3 years（range from 14 months to 5 years）.It was found that clinical symptoms completely disappeared and the results of laboratory tests were normal.Imaging studies showed all tuberculose focuses were healed and upper cervical spinal curvature was corrected.Kyphosis angle increased to 10° and more（10°,18°and 25°） in 3 patients with lower cervical lesions at the final follow-up.No corrective procedures were performed in the 17 patients after local chemotherapy.One patient with Frankel C recovered to normal E.There were no sinus,pseudarthrosis and recurrence at the final follow-up.Conclusion Local chemotherapy is an effective treatment of cervical tuberculosis.No obvious kyphosis exists after upper cervical tuberculosis is healed,while there are different degrees of kyphosis in some patients with lower cervical tuberculosis after local chemotherapy.
出处
《脊柱外科杂志》
2012年第1期29-31,共3页
Journal of Spinal Surgery
关键词
颈椎
结核
脊柱
脊柱后凸
药物疗法
联合
Cervical vertebrae
Tuberculosis
spinal
Kyphosis
Drug therapy
combination
