title: [Qualitative diagnosis and therapeutic strategy of atlanto-axial tuberculosis].
abstract: 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.
authors.affiliation: Department of Orthopaedics, Peking University Third Hospital, Beijing 100083, China. xglius@vip.sina.com.cn
authors.forename: Xiao-guang
authors.initials: XG
authors.lastname: Liu
authors.forename: Chao
authors.initials: C
authors.lastname: Wang
authors.forename: Zhong-jun
authors.initials: ZJ
authors.lastname: Liu
authors.forename: Geng-ting
authors.initials: GT
authors.lastname: Dang
mesh_terms: D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D001268:Atlanto-Axial Joint / Q000473:pathology*; D001707:Biopsy, Needle / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D006801:Humans; D008297:Male; D008875:Middle Aged; D013123:Spinal Fusion; D014399:Tuberculosis, Spinal / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy
chemical_list: D000995:Antitubercular Agents