[Qualitative diagnosis and therapeutic strategy of atlanto-axial tuberculosis]

OBJECTIVE: To investigate the qualitative diagnosis method of atlanto-axial tuberculosis and the corresponding therapeutic strategy. METHODS: Twenty-two cases with atlanto-axial tuberculosis proven by histopathologic diagnosis were observed. Three cases and 17 cases underwent trans-oral biopsy and CT-guide percutaneous biopsy respectively, 2 cases were conformed by frozen section in operation. Thirteen of the 22 cases underwent surgical therapy: 1 case with anterior trans-oral radical eradication and fusion under Halo-vest immobilization, 7 cases with anterior cervical radical eradication, 1 case with anterior interbody fusion and titanic plate fixation, 2 cases were with posterior atlantoaxial interlaminar fusion and 2 cases with posterior cervical occipito-axial titanic plate internal fixation and fusion. Other 9 cases accepted nonsurgical therapy: 8 cases with Halo-vest immobilization and 1 case with head halter traction. All cases were given appropriate antituberculotic chemotherapy for 12-18 months. RESULTS: All of the 22 cases were followed up, and the average time was 37 month. The lesion focus showed reparation and fusion in X-ray, and the results were satisfactory. CONCLUSIONS: Biopsy can acquire the qualitative diagnosis on atlanto-axial tuberculosis. The choice of therapy is made on the situation of cold abscess, pathological fracture, atlanto-axial dislocation and spinal cord compression

Keywords : Abscess,Adolescent,Adult,Antitubercular Agents,Atlanto-Axial Joint,Biopsy,Biopsy,Needle,Child,Child,Preschool,China,diagnosis,Female,Follow-Up Studies,Fracture Fixation,Internal,Humans,Immobilization,Male,methods,Middle Aged,pathology,Spinal Cord,Spinal Cord Compression,Spinal Fusion,therapeutic use,therapy,Time,Traction,Tuberculosis,Tuberculosis,Spinal,Universities,, Diagnosis,Therapeutic,Strategy, neck doctor

Date of Publication : 2007 Mar 15

Authors : Liu XG;Wang C;Liu ZJ;Dang GT;

Organisation : Department of Orthopaedics, Peking University Third Hospital, Beijing 100083, China. xglius@vip.sina.com.cn

Journal of Publication : Zhonghua Wai Ke Za Zhi

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/17537329

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