PDF(Pubmed)
Abstract：
UNASSIGNED: Tuberculosis (TB) of CT junction is uncommon (5 % of all spinal TB), and difficult to approach surgically in view of its deep location with sternum in front and scapula in the back. We present 7 consecutively treated cases of cervico-thoraccic TB for outcome of treatment and discuss rationale of choosing surgical approach.
UNASSIGNED: Present study includes 7 freshly diagnosed cases of CT junction TB. Plain radiographs, sagittal reconstruction of CT spine that included sternum on CT/MRI was performed in all cases. Disc space below the distal healthy vertebrae was identified and a line parallel to disc space was drawn. If this line passes above suprasternal notch, it was inferred that this VB can be accessed by anterior cervical approach. If disease focus was at or below suprasternal notch level, manubriotomy/sternotomy was added for better visualization of the lesion.
UNASSIGNED: All seven cases were female, with mean age of 20 years (9-45 years). The vertebral lesion involved 2VB (n = 3), 3VB (n = 2) and >3 VB (n = 2). The average Cervico-thoracic kyphosis was 15° (range 10-25°). All 7 cases were operated for anterior decompression, kyphotic deformity correction and instrumented stabilization. Anterior cervical approach and manubriotomy/sternotomy approach was performed in three cases each. In two pan-vertebral cases we performed 360° procedure. Six cases have shown first sign of neural recovery within 3 weeks of surgery and almost complete neural recovery at 3 months follow-up while one case showed partial recovery. ATT was stopped after 12 months once healed stage was demonstrated on contrast MRI in all.
UNASSIGNED: CT junction TB usually presents with severe kyphotic deformity/neural deficit. These cases require anterior decompression/corpectomy, deformity correction, gap grafting and instrumented stabilization with anterior cervical plate. Lesion with pan-vertebral disease is stabilized 360°. These lesions can be decompressed by lower anterior cervical approach with/without manubriotomy. The Karikari method was useful in deciding the need for manubriotomy to decompress the lesion.
UNASSIGNED: Present study includes 7 freshly diagnosed cases of CT junction TB. Plain radiographs, sagittal reconstruction of CT spine that included sternum on CT/MRI was performed in all cases. Disc space below the distal healthy vertebrae was identified and a line parallel to disc space was drawn. If this line passes above suprasternal notch, it was inferred that this VB can be accessed by anterior cervical approach. If disease focus was at or below suprasternal notch level, manubriotomy/sternotomy was added for better visualization of the lesion.
UNASSIGNED: All seven cases were female, with mean age of 20 years (9-45 years). The vertebral lesion involved 2VB (n = 3), 3VB (n = 2) and >3 VB (n = 2). The average Cervico-thoracic kyphosis was 15° (range 10-25°). All 7 cases were operated for anterior decompression, kyphotic deformity correction and instrumented stabilization. Anterior cervical approach and manubriotomy/sternotomy approach was performed in three cases each. In two pan-vertebral cases we performed 360° procedure. Six cases have shown first sign of neural recovery within 3 weeks of surgery and almost complete neural recovery at 3 months follow-up while one case showed partial recovery. ATT was stopped after 12 months once healed stage was demonstrated on contrast MRI in all.
UNASSIGNED: CT junction TB usually presents with severe kyphotic deformity/neural deficit. These cases require anterior decompression/corpectomy, deformity correction, gap grafting and instrumented stabilization with anterior cervical plate. Lesion with pan-vertebral disease is stabilized 360°. These lesions can be decompressed by lower anterior cervical approach with/without manubriotomy. The Karikari method was useful in deciding the need for manubriotomy to decompress the lesion.
摘要：
■CT交界处的结核（TB）并不常见（占所有脊柱TB的5％），鉴于其位置较深，胸骨在前面，肩胛骨在后面，因此难以手术接近。我们介绍了7例连续治疗的颈胸结核的治疗结果，并讨论了选择手术方法的理由。
■本研究包括7例新诊断的CT交界结核病例。普通射线照片,所有病例均进行CT/MRI上包括胸骨的CT脊柱矢状重建。确定了远端健康椎骨下方的椎间盘空间，并绘制了一条平行于椎间盘空间的线。如果这条线越过胸骨上切迹，推断该VB可以通过颈椎前路进入。如果疾病焦点在胸骨上切口水平或以下，增加了手动切开术/胸骨切开术，以更好地观察病变。
■所有7例病例均为女性，平均年龄20岁（9-45岁）。椎体病变累及2VB(n=3),3VB(n=2)和>3VB(n=2)。平均胸椎后凸为15°（范围10-25°）。7例均行前路减压手术,后凸畸形矫正和仪器稳定。前颈入路和手动切开/胸骨切开术各3例。在两个全脊椎病例中，我们进行了360°手术。6例患者在手术后3周内首次出现神经恢复迹象，随访3个月时神经基本恢复，1例部分恢复。12个月后，一旦在对比MRI上显示出治愈阶段，就停止ATT。
■CT交界处TB通常表现为严重的后凸畸形/神经缺陷。这些病例需要前路减压/全身切除术，畸形矫正,用颈椎前板进行间隙移植和器械稳定。全椎病变360°稳定。这些病变可以通过下颈椎前入路减压，有/无手术切开术。Karikari方法可用于确定是否需要切开切开以减压病变。
■本研究包括7例新诊断的CT交界结核病例。普通射线照片,所有病例均进行CT/MRI上包括胸骨的CT脊柱矢状重建。确定了远端健康椎骨下方的椎间盘空间，并绘制了一条平行于椎间盘空间的线。如果这条线越过胸骨上切迹，推断该VB可以通过颈椎前路进入。如果疾病焦点在胸骨上切口水平或以下，增加了手动切开术/胸骨切开术，以更好地观察病变。
■所有7例病例均为女性，平均年龄20岁（9-45岁）。椎体病变累及2VB(n=3),3VB(n=2)和>3VB(n=2)。平均胸椎后凸为15°（范围10-25°）。7例均行前路减压手术,后凸畸形矫正和仪器稳定。前颈入路和手动切开/胸骨切开术各3例。在两个全脊椎病例中，我们进行了360°手术。6例患者在手术后3周内首次出现神经恢复迹象，随访3个月时神经基本恢复，1例部分恢复。12个月后，一旦在对比MRI上显示出治愈阶段，就停止ATT。
■CT交界处TB通常表现为严重的后凸畸形/神经缺陷。这些病例需要前路减压/全身切除术，畸形矫正,用颈椎前板进行间隙移植和器械稳定。全椎病变360°稳定。这些病变可以通过下颈椎前入路减压，有/无手术切开术。Karikari方法可用于确定是否需要切开切开以减压病变。
