[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.
Liu
Xiao-guang
XG
Department of Orthopaedics, Peking University Third Hospital, Beijing 100083, China. xglius@vip.sina.com.cn
Wang
Chao
C
Liu
Zhong-jun
ZJ
Dang
Geng-ting
GT
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
D000995:Antitubercular Agents