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首页> 外文期刊>Spine >Craniovertebral tuberculosis: a retrospective review of 13 cases managed conservatively.
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Craniovertebral tuberculosis: a retrospective review of 13 cases managed conservatively.

机译：颅脑结核：13例保守治疗的回顾性回顾。

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STUDY DESIGN: Retrospective review of 13 cases with craniovertebral tuberculosis treated conservatively. OBJECTIVE: To evaluate the results of conservative treatment of craniovertebral tuberculosis and compare with the literature. SUMMARY OF BACKGROUND DATA: Craniovertebral tuberculosis is a rare entity even in endemic countries, and there is no consensus in the literature regarding conservative or surgical management for the same. Reports range from radical surgery to totally conservative approach. We report our experience in treating such patients conservatively. METHODS: A retrospective review of 13 patients diagnosed with craniovertebral tuberculosis was performed. All patients were treated conservatively with cervical traction for initial 3 months followed by a brace along with multidrug antitubercular drugs for 18 months. RESULTS: All patients responded favorably to conservative treatment. Follow-up averaged 43 months (range, 16-65 months). No patient deteriorated neurologically. All patients hadsymptomatic improvement. Failure to reduce atlantoaxial dislocation/lateral subluxation of the dens completely was seen in 2 cases. CONCLUSIONS: We think that all patients with craniovertebral junction tuberculosis can be managed adequately using conservative means regardless of the extent of bony destruction with a good patient outcome. Surgery should be reserved for only a selective few where diagnosis is in doubt and there is initial severe or progressive neural deficit with/without respiratory distress in presence of documented mechanical compression and documented dynamic instability following conservative treatment.
机译：研究设计：回顾性分析13例保守治疗的颅脑结核。目的：评价保守治疗颅脑结核的疗效，并与文献进行比较。背景资料摘要：即使在流行国家，颅脑结核病也是一种罕见的病因，在文献中关于保守治疗或手术治疗尚无共识。报告范围从根治性手术到完全保守的方法。我们报告保守治疗此类患者的经验。方法：回顾性分析13例确诊为颅脑结核的患者。所有患者在开始的3个月内均接受了颈椎牵引术的保守治疗，随后进行了支架治疗以及18个月的多药抗结核药物治疗。结果：所有患者对保守治疗反应良好。平均随访43个月（范围16-65个月）。没有患者在神经方面恶化。所有患者症状都有改善。在2例中未见完全减少牙本质的寰枢椎脱位/外侧半脱位。结论：我们认为，不管骨质破坏的程度如何，所有的颅骨交界结核患者都可以采用保守方法进行适当治疗，并取得良好的患者预后。手术应仅针对少​​数有诊断怀疑的手术，并且在存在保守治疗后出现机械性压迫和动态不稳定性的情况下，最初会出现严重的或进行性神经功能缺损，并伴有或没有呼吸窘迫。

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