本文以24例颈椎感染性炎性病变的实际战术分类及其应用为例

A. Bazarov
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引用次数: 2

摘要

目标。以作者的临床资料为例,分析已知的颈椎感染性和炎性病变的分类。材料和方法。对24例颈椎病变患者的治疗结果进行了分析。采用L. Homagk(2016)、E. Pola(2017)、M. Akbar(2012)和H. Almansour(2020)等作者小组提出的分类进行比较。24例颈椎骨髓炎患者中,单节段性病变15例,多节段性病变5例,多节段性病变2例,多节段性病变2例。C5-C6节段在70.8%的病例中受到影响。2例(8.3%)患者被诊断为败血症。1例未分类,因有C1-C2节段病变。神经功能缺损16例(66.7%)。急性型20例(83.3%),慢性型4例(16.7%)。20例(83.3%)患者接受手术治疗。住院死亡率为8.3% (n = 2),康复率为91.7% (n = 22)。对上述分类进行了分析,并提出了使用建议。Pola等人的《化脓性椎板炎的新分类》是一种修改后的分类,明确了不稳定标准和颈椎手术治疗方法的适应性,可以将其作为主要的治疗和诊断算法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Actual tactical classifications of the infectious inflammatory lesions of the cervical spine and their use on the example of a series of 24 cases
Objective. To analyze the known classifications of infectious and inflammatory lesions of the cervical spine using the example of the author’s clinical material.Material and Methods. Data on the results of treatment of 24 patients with lesions of the cervical spine were analyzed. Classifications proposed by groups of authors led by L. Homagk (2016) E. Pola (2017), M. Akbar (2012) and H. Almansour (2020) were used for comparison.Results. Out of 24 patients with osteomyelitis of the cervical spine, monosegmental lesions were observed in 15, polysegmental – in 5, multilevel – in 2, and multilevel polysegmental lesions – in 2 cases. The C5–C6 segment was affected in 70.8 % of cases. Sepsis was diagnosed in 2 (8.3 %) patients. One case was not classified, as there was a lesion of the C1–C2 segment. The total number of neurological deficit  was 16 (66.7 %). Twenty (83.3 %) patients were admitted with the acute form of the disease, and 4 (16.7 %) patients with the chronic form. Surgery was performed in 20 (83.3 %) patients. Hospital mortality was 8.3 % (n = 2), 91.7 % (n = 22) of patients recovered. The analysis of the classifications presented above was carried out, and proposals for their use were outlined.Conclusion. «New Classification of Pyogenic Spondylodiscitis» by Pola et al., a modified classification with specification of instability criteria and adaptation of surgical methods of treatment for the cervical spine allows applying it as the main treatment and diagnostic algorithm.
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