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首页> 外文期刊>Indian journal of orthopaedics >Late-Onset Paraplegia in Old Healed Spinal Tuberculosis Due to Traumatic Fracture of Fusion Mass – A Rare Case Report
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Late-Onset Paraplegia in Old Healed Spinal Tuberculosis Due to Traumatic Fracture of Fusion Mass – A Rare Case Report

机译：融合块的外伤性骨折导致旧的治愈型脊椎结核迟发性截瘫–罕见病例报告

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The natural healing of spinal tuberculosis occurs by spontaneous fusion of vertebral bodies with or without kyphotic deformity. Late-onset paraplegia secondary to the fracture of fusion mass in tuberculosis is one of the rare conditions which have not been extensively reported. A 56-year-old male patient sustained road traffic accident was diagnosed with a fracture of fusion mass in already healed tuberculosis. He was presented with weakness in both the lower limbs with ASIA-C grading of spinal cord injury. He was treated with posterior instrumented stabilization and decompression. The patient recovered well postoperatively and had regained his complete power of both lower limbs. Late-onset paraplegia in old healed spinal tuberculosis is a well-known entity that may be caused due to transaction of the cord by a bony ridge or when the formed granulation or fibrous tissue constricts the cord. Fusion mass fractures are not very uncommon in conditions such as ankylosing spondylitis or diffuse idiopathic skeletal hyperostosis. Traumatic fractures tend to occur at the adjacent vertebral bodies to the fused ones as the biomechanical stress at the junctional site is far higher than at the center of the fused mass. In healed spinal tuberculosis, resultant deformity would be kyphosis. The angle of kyphosis is directly proportional to the resulting neurological deficit. Fractures of fused mass in healed tuberculosis are similar to the fractures in other ossifying bone lesions. The purpose of this article is to document the rare possibility of late-onset paraplegia in uninstrumented old healed spinal tuberculosis with kyphotic deformity, due to the fracture of fusion mass as seen in ankylosing spondylitis.
机译：脊椎结核的自然愈合是通过椎体自发融合而发生或不发生后凸畸形而发生的。结核中融合块破裂继发的迟发性截瘫是罕见病之一，尚未得到广泛报道。一名56岁的男性患者持续道路交通事故被诊断为已经治愈的肺结核融合块破裂。脊髓损伤的ASIA-C分级显示他的下肢无力。他接受了后路仪器稳定和减压治疗。病人术后恢复良好，并恢复了他的下肢全部力量。老年的治愈型脊椎结核中的迟发性截瘫是众所周知的实体，可能是由于骨脊对脐带的交易或当形成的肉芽或纤维组织使脐带收缩而引起的。在强直性脊柱炎或弥漫性特发性骨骼肥大的情况下，融合性大块骨折并不是很常见。创伤性骨折往往发生在与融合椎体相邻的椎体上，这是因为在交界处的生物力学应力远高于融合质心处的生物力学应力。在治愈的脊椎结核中，导致的畸形将是后凸畸形。驼背的角度与神经功能缺损成正比。治愈的结核中融合块的骨折与其他骨化性骨病变中的骨折相似。本文的目的是记录由于强直性脊柱炎中融合块破裂而导致的未器械化的旧式脊柱结核合并后凸畸形的迟发性截瘫的罕见可能性。

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