Interdisciplinary Neurosurgery: Advanced Techniques and Case Management最新文献_第6页

Analysis of the treatment pathway and causes of delay in a young patient with spinal arteriovenous malformations: A case report 年轻脊髓动静脉畸形患者治疗途径及延误原因分析：1例报告

IF 0.5 Q4 CLINICAL NEUROLOGY

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management

Pub Date : 2025-12-12 DOI: 10.1016/j.inat.2025.102159

Guiying Liu , Lifang Wen , Yanyan Zhang , Dan Zhao , Ling Tang , Xin Guan

Background

Spinal arteriovenous malformations (SAVMs) are rare, Early insidious, non-specific symptoms cause diagnostic delay—higher in adolescents—leading to psychological distress, educational interruption, poor prognosis, and more. Timely intervention improves outcomes, but research on young patients’ pre-admission clinical trajectory is limited.

Case presentation

A 20-year-old male with 1-month lower limb weakness/numbness and sphincter disturbance was diagnosed with SAVMs. Initial low back pain was ignored due to his intense training but symptoms progressed to urinary/defecatory dysfunction. Spinal CT was normal, MRI showed T9-L3 abnormal signals and T8-T12 spinal cord edema. Even with worsening symptoms every day the time from the discovery of the symptoms to the acceptance of the correct treatment was 40 days.

Intervention

The young man had endovascular embolization (DSA + EMB) at a tertiary hospital. Access to the right common femoral artery was gained via the Seldinger method, delivering embolic agents(N-butyl cyanoacrylate NBCA) into this vessel, control angiography confirmed a significant reduction in both blood flow velocity and volume within the malformed vasculature. Post-rehabilitation, 3-month follow-up showed normal walking, recovered defecation, Urinary Functionand improved neurological function (Aminoff & Logue Scale changed from 7to 0.

Conclusion

Diagnostic delays stem from atypical symptoms, primary physicians’ limited experience, and poor early screening. Strategies like physician training, optimized diagnostics, and public education are recommended to improve timely SAVM care.

脊髓动静脉畸形（SAVMs）是罕见的，早期隐匿的，非特异性的症状导致诊断延迟-在青少年中更高-导致心理困扰，教育中断，预后不良等。及时干预可以改善预后，但对年轻患者入院前临床轨迹的研究有限。一例20岁男性患者，下肢无力/麻木及括约肌障碍1个月，诊断为SAVMs。由于他的高强度训练，最初的腰痛被忽略，但症状发展为尿/排便功能障碍。脊髓CT正常，MRI示T9-L3异常信号，T8-T12脊髓水肿。即使症状每天都在恶化，从发现症状到接受正确治疗的时间也是40天。患者在三级医院行血管内栓塞术（DSA + EMB）。通过Seldinger方法进入右股总动脉，将栓塞剂（n -丁基氰基丙烯酸酯NBCA）送入该血管，控制血管造影证实畸形血管内血流速度和体积显著减少。康复后随访3个月，行走正常，排便、泌尿功能恢复，神经功能改善（Aminoff & Logue评分从7分提高到0分）。结论临床症状不典型、初级医师经验不足、早期筛查不到位是延误诊断的主要原因。建议采取诸如医生培训、优化诊断和公众教育等策略来改善及时的SAVM护理。

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引用次数: 0

Evaluating the impact of varying positive end-expiratory pressure on intracranial pressure via optic nerve sheath diameter sonography in adults with brain injury 通过视神经鞘直径超声评估成人脑损伤患者不同呼气末正压对颅内压的影响

IF 0.5 Q4 CLINICAL NEUROLOGY

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management

Pub Date : 2025-12-11 DOI: 10.1016/j.inat.2025.102154

Mansoor Masjedi , Ramin Tajvidi , Farid Zand , Golnar Sabetian , Naeimehossadat Asmarian , Mahsa Banifatemi

Background

Traumatic brain injury(TBI) is a significant cause of mortality and disability in adults. Intracranial pressure(ICP) is typically measured invasively, while the noninvasive measurement of optic nerve sheath diameter(ONSD) is gaining popularity as a surrogate. Positive end-expiratory pressure(PEEP), a key component of mechanical ventilation, has been found to affect ICP. This study aimed to evaluate the effect of different PEEP values on ONSD and to correlate these changes with direct ICP measurements.

Material and methods

This prospective observational study enrolled 12 adult patients with severe TBI admitted to the ICU, requiring invasive ICP monitoring. The ONSD was examined using ultrasound at PEEP levels of 5,7,10,and 12cmH₂O, while the ICP was measured concurrently using an external ventricular drain(EVD).

Results

Increasing PEEP from 7 to 10 cmH₂O significantly increased the right ONSD(P = 0.002) but did not significantly affect the left ONSD(P > 0.016). The mean ONSD increased significantly with each incremental step in PEEP(P < 0.016). ICP also increased significantly when PEEP was changed from 7 to 10 cmH₂O(P = 0.002), but it remained within a normal range(ICP < 20 mmHg). Importantly, increasing PEEP did not significantly affect cerebral perfusion pressure(CPP) (P > 0.016). An ONSD > 5.30 mm was found to predict an ICP > 17 cmH₂O with 83.33 % sensitivity and 82.79 % specificity(AUC = 0.904, P < 0.001).

Conclusion

In patients with TBI and normal baseline ICP, PEEP can be safely increased up to 12 cmH₂O without compromising CPP. The mean ONSD can be used as a reliable, noninvasive tool to monitor for PEEP-induced changes in ICP, with an ONSD of 5.30 mm serving as a critical threshold.

背景：创伤性脑损伤（TBI）是导致成人死亡和残疾的重要原因。颅内压（ICP）通常是有创测量，而视神经鞘直径（ONSD）的无创测量作为替代方法越来越受欢迎。正呼气末压（PEEP）是机械通气的关键组成部分，已被发现影响ICP。本研究旨在评估不同PEEP值对ONSD的影响，并将这些变化与直接ICP测量相关联。材料和方法本前瞻性观察性研究纳入了12例入住ICU、需要侵入性ICP监测的严重TBI成年患者。在正压5、7、10和12cmH2O水平下使用超声检查ONSD，同时使用外心室引流（EVD）测量ICP。结果PEEP从7 cmH2O增加到10 cmH2O显著增加右侧ONSD(P = 0.002)，但对左侧ONSD无显著影响（P > 0.016）。平均ONSD随着PEEP的增加而显著增加（P < 0.016）。当PEEP从7 ~ 10 cmH2O时，ICP也显著升高（P = 0.002），但仍在正常范围内（ICP + lt; 20 mmHg）。重要的是，PEEP升高对脑灌注压（CPP）无显著影响（P > 0.016）。发现ONSD >； 5.30 mm预测ICP >； 17 cmH2O具有83.33%的敏感性和82.79%的特异性（AUC = 0.904, P < 0.001）。结论在颅内压基线正常的TBI患者中，PEEP可安全升高至12 cmH2O而不影响CPP。平均ONSD可以作为一种可靠的、无创的工具来监测peep引起的ICP变化，ONSD为5.30 mm作为临界阈值。

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引用次数: 0

Corrigendum to “Cryptogenic pituitary abscess: Two case reports from Indonesia highlighting diagnostic challenges and atypical clinical-radiological features” [Interdiscip. Neurosurg. 40 (2025) 102057] “隐源性垂体脓肿：印度尼西亚两例病例报告，突出诊断挑战和非典型临床放射学特征”的更正[交叉学科]。神经外科。40 (2025)102057]

IF 0.5 Q4 CLINICAL NEUROLOGY

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management

Pub Date : 2025-12-01 DOI: 10.1016/j.inat.2025.102073

Donny Wisnu Wardhana , Farhad Balafif , Tommy Alfandy Nazwar , Fachriy Balafif , Ibrahim Yusuf Nasution , Saddam Husein Saputra , Koernia Hezkia Yonathan , Anisa Nur Kholipah

引用次数: 0

An infant presenting with an occipital encephalocele containing an epidermoid cyst: a rare case report 婴儿表现为枕骨脑膨出伴表皮样囊肿：罕见病例报告

IF 0.5 Q4 CLINICAL NEUROLOGY

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management

Pub Date : 2025-12-01 DOI: 10.1016/j.inat.2025.102137

Shuvro Saha , Saumitra Sarkar , Md. Shah Alam Bhuiyan , Md. Shahadat Hossain Sarker

Encephalocele is a congenital neural tube defect characterized by the herniation of intracranial contents through a defect in the skull bone. An epidermoid cyst is an ectodermal cell-containing lesion in an abnormal location.

We present a case of an infant who has been exhibiting a midline occipital swelling since birth. Clinical and radiological evaluations confirmed the presence of an occipital encephalocele. During surgery, the sac contained an epidermoid cyst, in addition to necrosed brain tissue and cerebrospinal fluid. The cyst was excised entirely, and the encephalocele was repaired. The postoperative period was uneventful, and the infant recovered well.

An epidermoid cyst arising within an occipital encephalocele is a rare congenital anomaly. As far as we know, this is the first documentation of such an association. This article details the comprehensive management of this unique case, including the presentation, diagnostic assessments, surgical interventions, and additional supportive care measures.

脑膨出是一种先天性神经管缺损，其特征是颅内内容物通过颅骨缺损突出。表皮样囊肿是位于异常位置的外胚层细胞病变。我们提出一个病例的婴儿谁一直表现出中线枕骨肿胀，因为出生。临床和放射学评估证实存在枕部脑膨出。手术中，囊内有表皮样囊肿，还有坏死的脑组织和脑脊液。囊肿被完全切除，脑膨出被修复。术后顺利，患儿恢复良好。摘要发生于枕部脑膨出的表皮样囊肿是一种罕见的先天性异常。据我们所知，这是这种联系的第一份文件。本文详细介绍了这一独特病例的综合管理，包括表现、诊断评估、手术干预和额外的支持性护理措施。

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引用次数: 0

Building clinician trust in AI-assisted neurodiagnostics: A case-based evaluation 建立临床医生对人工智能辅助神经诊断的信任：基于病例的评估

IF 0.5 Q4 CLINICAL NEUROLOGY

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management

Pub Date : 2025-11-17 DOI: 10.1016/j.inat.2025.102144

K.S.V. Angu Bala Ganesh , Ved Prakash Mishra , A. Jayanthiladevi , Amit Kumar Verma

Neurodiagnostics and AI: How Artificial Intelligence is changing the Future of Neurodiagnostics. Clinician trust is critical for successfully adopting AI-assisted tools in clinical settings. Here, we evaluate clinician trust in AI-based neurodiagnostic solutions using a simulated multicast-medicine scenario about stroke, neurodegenerative disease, and traumatic brain injury (TBI). Then, we study the reliability, explainability, and acceptance of the AI-generated diagnoses by both the deep learning models and XAI (explainable AI) methods. These results pinpoint significant predictors of clinician confidence and pathways for potential interventions to induce AI adaptation in neurodiagnostics. AI revolutionizes neurodiagnostics and provides more effective and cost-effective methods to detect neuro diseases. But clinicians’ trust in these tools is essential for the successful implementation of AI in clinical practice. This study evaluates clinician trust in AI neurodiagnostic tools in different clinical vignette cases based on those associated with reliability, interpretability, and agreement between AI models and expert judgments. We assess clinician responses (including those of IS, TBI, and neurodegenerative diseases) to AI-generated diagnoses using an AI-based decision-support system with deep learning and explainable AI methods. Our findings add to a growing understanding of factors that could influence clinician uptake and strategies to optimize AI-enabled diagnostic use in neurologic practice.

神经诊断和人工智能：人工智能如何改变神经诊断的未来。临床医生的信任对于在临床环境中成功采用人工智能辅助工具至关重要。在这里，我们通过模拟卒中、神经退行性疾病和创伤性脑损伤（TBI）的多医学场景来评估临床医生对基于人工智能的神经诊断解决方案的信任。然后，我们研究了深度学习模型和XAI（可解释的AI）方法对人工智能生成诊断的可靠性、可解释性和可接受性。这些结果指出了临床医生信心的重要预测因素，以及在神经诊断中诱导人工智能适应的潜在干预途径。人工智能彻底改变了神经诊断，并提供了更有效和更具成本效益的方法来检测神经疾病。但临床医生对这些工具的信任对于在临床实践中成功实施人工智能至关重要。本研究基于AI模型与专家判断之间的可靠性、可解释性和一致性，评估了临床医生在不同临床病例中对AI神经诊断工具的信任。我们使用具有深度学习和可解释的人工智能方法的基于人工智能的决策支持系统评估临床医生对人工智能生成诊断的反应（包括IS， TBI和神经退行性疾病）。我们的研究结果增加了对可能影响临床医生吸收和优化神经病学实践中人工智能诊断使用策略的因素的日益了解。

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引用次数: 0

Supratentorial ependymoma with giant cells of the corpus callosum: A case report 伴有胼胝体巨细胞的幕上室管膜瘤1例

IF 0.5 Q4 CLINICAL NEUROLOGY

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management

Pub Date : 2025-11-16 DOI: 10.1016/j.inat.2025.102151

K. Kundhavai , B. Archana , Lawrence D Cruze , P. Bhaskar Naidu

Ependymomas involving the corpus callosum are relatively rare tumours of the central nervous system which poses diagnostic and therapeutic challenge to the treating clinician. Ependymomas with presence of giant cells are uncommon histological findings. Here we present an interesting case of an 8-year-old male child with a space occupying lesion arising from the body of the corpus callous on the left side, which was diagnosed as Supratentorial ependymoma Grade 3 by histopathology and immunohistochemistry on initial biopsy after considering the differential diagnosis of other lesions of the central nervous system with similar histomorphology. The patient received radiation therapy, however lesion recurred within a period of 10 months. Subsequently histopathology revealed the presence of predominantly numerous highly pleomorphic bizarre cells and multinucleate giant cells arranged in sheets having brisk mitosis (15/10HPF) with adjacent areas of necrosis and haemorrhage, implying the aggressive nature of the lesion.

涉及胼胝体的室管膜瘤是相对罕见的中枢神经系统肿瘤，对临床医生的诊断和治疗提出了挑战。室管膜瘤伴巨细胞是罕见的组织学表现。我们在此报告一例有趣的病例，一名8岁男童左侧胼胝体占位性病变，经组织病理学和免疫组织化学初步活检诊断为幕上室管膜瘤3级，与其他具有相似组织形态的中枢神经系统病变鉴别诊断相结合。患者接受放射治疗，但病变在10个月内复发。随后的组织病理学显示大量高度多形性的奇异细胞和多核巨细胞排列成片状，有丝分裂活跃（15/10HPF），邻近坏死和出血区域，表明病变具有侵袭性。

引用次数: 0

Consult and kyphoplasty delay impacts on geriatric vertebral compression fracture outcomes 咨询和后凸成形术延迟对老年椎体压缩性骨折结果的影响

IF 0.5 Q4 CLINICAL NEUROLOGY

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management

Pub Date : 2025-11-16 DOI: 10.1016/j.inat.2025.102150

Vithushan Surendran , Victoria Shi , Desmond Kwok , Amanda Martyniuk , Markian Pahuta , Daipayan Guha

Objective

To determine the association between the delay in a neurosurgical consultation and subsequent kyphoplasty following the radiological diagnosis of a vertebral compression fracture (VCF), and surgical outcomes.

Methods

A retrospective cohort study was conducted on elderly patients (60 years or older) who underwent kyphoplasty at Hamilton Health Sciences (HHS) between 2012 and 2022, with a prior admission under Internal Medicine or non-spine-surgical specialties at HHS within two years prior to surgery. The primary outcomes were the progression of vertebral height loss and focal kyphotic deformity at diagnosis, prior to kyphoplasty, and post-kyphoplasty.

Results

The study included 108 patients (53.7 % female, 46.3 % male, mean age 70.5 years), with 119 surgeries. Thoracic and lumbar spine VCFs were present in 60 (55.6 %) and 76 (70.4 %) patients, respectively. A significant increase in vertebral height loss was observed before kyphoplasty (8.45 %; 95 % CI 4.70 % – 12.21 %, p < 0.0001) and a robust augmentation of vertebral height was observed after kyphoplasty (−6.81 %; 95 % CI −12.07 % – −1.55 %, p = 0.0122). However, no significant correlations were found between delay times and changes in vertebral height or focal kyphotic deformity.

Conclusion

Delays in neurosurgical consultation and kyphoplasty do not significantly affect radiographic outcomes in elderly patients with VCF. Despite restoration of vertebral height loss, the timing of intervention post-diagnosis does not influence the radiographic outcomes studied. This finding emphasizes the need for timely patient care while suggesting that delayed treatment might not adversely affect certain key radiographic metrics in elderly VCF patients.

目的探讨影像学诊断椎体压缩性骨折（VCF）后延迟神经外科会诊和后续后凸成形术与手术结果之间的关系。方法对2012 - 2022年间在汉密尔顿健康科学（HHS）接受后凸成形术的老年患者（60岁及以上）进行回顾性队列研究，这些患者术前2年内在HHS内科或非脊柱外科专业住院。主要结果是诊断时、后凸成形术前和后凸成形术后椎体高度下降和局灶性后凸畸形的进展。结果纳入108例患者，其中女性53.7%，男性46.3%，平均年龄70.5岁，手术119例。分别有60例（55.6%）和76例（70.4%）患者出现胸椎和腰椎vcf。后凸成形术前观察到椎体高度损失显著增加（8.45%;95% CI 4.70% - 12.21%, p < 0.0001），后凸成形术后观察到椎体高度显著增加（- 6.81%;95% CI - 12.07% - - 1.55%, p = 0.0122）。然而，延迟时间与椎体高度或局灶性后凸畸形的变化之间没有明显的相关性。结论延迟神经外科会诊和后凸成形术对老年VCF患者影像学结果无显著影响。尽管可以恢复椎体高度损失，但诊断后干预的时机并不影响所研究的影像学结果。这一发现强调了及时患者护理的必要性，同时表明延迟治疗可能不会对老年VCF患者的某些关键放射学指标产生不利影响。

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引用次数: 0

A case of rapidly increasing cabergoline-resistant male prolactinoma 迅速增加的耐卡麦角碱男性催乳素瘤1例

IF 0.5 Q4 CLINICAL NEUROLOGY

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management

Pub Date : 2025-11-15 DOI: 10.1016/j.inat.2025.102147

Toshiya Ichinose, Yasuo Sasagawa, Mitsutoshi Nakada

Cabergoline, a dopamine agonist, is the first-line drug for treating prolactinoma. However, some rare cases exhibit resistance to cabergoline. Here, we report a rare case of prolactinoma in a male patient that recurred in a short period while the patient was undergoing cabergoline treatment following tumor resection. A 50-year-old man was diagnosed with a pituitary tumor (Knosp grade 3) and presented with symptoms of decreased libido, erectile dysfunction, and bilateral hemianopia. He underwent endoscopic transnasal pituitary tumor resection. The pathological diagnosis was prolactinoma. The intrasellar tumor was excised, except around the bilateral cavernous sinus, improving the patient’s visual dysfunction. However, despite postoperative treatment with cabergoline, the residual tumor rapidly enlarged, and the bilateral hemianopia recurred. The second tumor resection was performed 15 months after the initial surgery. The patient’s visual field loss once more improved, and postoperative oral cabergoline treatment was resumed. However, radiation therapy was required because the residual tumor in the cavernous sinus grew back. Since then, the patient’s condition has remained stable, and the tumor did not enlarge. In this case, the patient consistently showed strong resistance to cabergoline and required surgery and radiation therapy due to early recurrence of tumor growth after the initial surgery. Combined therapy involving surgical resection and radiotherapy may be beneficial for male patients with cabergoline-resistant prolactinoma.

卡麦角林是一种多巴胺激动剂，是治疗催乳素瘤的一线药物。然而，一些罕见的病例对卡麦角林有耐药性。在此，我们报告一例罕见的男性催乳素瘤患者，在肿瘤切除后接受卡麦角林治疗时，在短时间内复发。一位50岁的男性被诊断为垂体瘤（Knosp 3级），并表现出性欲下降、勃起功能障碍和双侧偏视的症状。经鼻内镜切除垂体瘤。病理诊断为泌乳素瘤。除双侧海绵窦周围外，鞍内肿瘤被切除，改善了患者的视力障碍。然而，尽管术后用卡麦角林治疗，残余肿瘤迅速扩大，双侧偏视复发。第二次肿瘤切除术在初次手术后15个月进行。患者视野丧失再次改善，术后恢复口服卡麦角林治疗。然而，由于海绵窦的残余肿瘤复发，需要放射治疗。从那时起，患者的病情一直保持稳定，肿瘤没有扩大。本例患者对卡麦角林一直表现出较强的耐药性，由于初次手术后肿瘤生长早期复发，需要手术和放疗。包括手术切除和放疗的联合治疗可能有利于男性卡麦角碱耐药催乳素瘤患者。

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引用次数: 0

Management of high-grade glioma in pregnancy: Case report and review of the literature 妊娠期高级别胶质瘤的处理：病例报告及文献回顾

IF 0.5 Q4 CLINICAL NEUROLOGY

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management

Pub Date : 2025-11-15 DOI: 10.1016/j.inat.2025.102145

Miguel A. Hernandez-Rovira , Tyler Bales , Keerthana N. Prabhu , Brianna Augustin , Asia Carey , Sonika Dahiya , Francis S. Wu , David N. Loy , Ali Y. Mian , Omar Butt , Albert H. Kim , Dimitrios Mathios

Although high-grade gliomas most commonly present in older individuals, they infrequently present in women of childbearing age. We report the case of a 27-year-old woman previously diagnosed with a grade 4 astrocytoma who became pregnant during treatment. The patient had a stable pregnancy until the perinatal period, when she experienced worsening headache, nausea, and vomiting, and was confirmed to have disease recurrence. Labor was induced at the 37th week of gestation with delivery of a healthy neonate. With the low incidence of high-grade gliomas in the pregnant population and resulting paucity of literature, there is no consensus on the treatment strategy for this population. To better characterize this disease process and investigate the optimal management of these challenging cases, we reviewed the literature and identified 81 cases of high-grade gliomas in pregnant individuals, but we were unable to identify any factors associated with increased survival. We discuss topics of importance to physicians managing these complex cases and make suggestions for the management of common issues for this patient population.

虽然高级别胶质瘤最常见于老年人，但很少见于育龄妇女。我们报告一个27岁的妇女以前诊断为4级星形细胞瘤谁在治疗期间怀孕。患者妊娠稳定，直至围产期，头痛、恶心、呕吐加重，确认疾病复发。妊娠第37周引产，生下健康新生儿。由于高级别胶质瘤在妊娠人群中的发病率较低，导致文献匮乏，因此对该人群的治疗策略尚无共识。为了更好地描述这种疾病的过程并研究这些具有挑战性的病例的最佳治疗方法，我们回顾了文献并确定了81例妊娠个体的高级别胶质瘤，但我们无法确定与生存率增加相关的任何因素。我们讨论重要的话题，医生管理这些复杂的情况下，并提出建议，为这一患者群体的共同问题的管理。

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引用次数: 0

Evaluating the effect of autologous bone graft impregnated with rifampicin and isoniazid on the rate of spinal fusion in a porcine animal model – A literature review 评估利福平和异烟肼浸染的自体骨移植物对猪动物模型脊柱融合率的影响-文献综述

IF 0.5 Q4 CLINICAL NEUROLOGY

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management

Pub Date : 2025-11-15 DOI: 10.1016/j.inat.2025.102146

Patrick Lekgwara, Adrian Kelly

Tuberculosis is a disease of poverty with a global concentration in sub-Saharan Africa. While 10% of extra-pulmonary tuberculosis is skeletal, 50% of this occurs in the spinal column. Besides the surgical management of spinal tuberculosis, medical management is an important adjunct. In surgical candidates, interventions commonly involve drainage of any pre- and para-vertebral tuberculous abscesses, debridement of devitalized necrotic vertebral tissue, an instrumented or non-instrumented anterior spinal column construction and fusion, augmented by an instrumented or non-instrumented lateral or posterolateral spinal fusion. To date no clinical control study has ever been conducted to evaluate the effect of a mixture of morselized autologous bone graft and the ceramic bone graft substitute calcium phosphate, impregnated with a single equivalent weight-adjusted oral dose of rifampicin and isoniazid in a ratio of 2:1, as characterizes a single human oral dose, on the rate of spinal fusion, when used as an on lay in the context of achieving a single level non-instrumented posterolateral spinal fusion, in neither a human nor porcine animal model. Due to the effects of local anti-tubercular antibiotic therapy currently being unknown, and therefore unsafe for in vitro human application, our literature review aimed to evaluate the current state of knowledge on what would be the effect of an interventional mixture of morselized autologous bone graft and ceramic bone graft the substitute, namely calcium phosphate paste, impregnated with a single equivalent weight-adjusted oral dose of rifampicin and isoniazid, on the rate of posterolateral spinal fusion in a porcine animal model. We hope that this literature review will be followed by an in vitro animal study using a porcine model, which if safe and demonstrates benefit, could be expanded to the in vitro human model in patients with spinal tuberculosis who meet criteria for surgical intervention.

结核病是一种贫穷疾病，全球主要集中在撒哈拉以南非洲。10%的肺外结核发生在骨骼，50%发生在脊柱。脊柱结核的外科治疗之外，医学治疗是重要的辅助手段。在外科候选人中，干预措施通常包括椎前和椎旁结核性脓肿的引流，失活坏死椎组织的清创，有器械或无器械的前脊柱构建和融合，辅以有器械或无器械的外侧或后外侧脊柱融合。迄今为止没有临床对照研究进行了评估的影响的混合物morselized自体骨移植和陶瓷植骨替代磷酸钙,浸渍用一个等效的体重调整一下给口服剂量的利福平和异烟肼在2:1的比例,作为描述一个人口服剂量,在脊柱融合的速度,当用作躺在的背景下实现单层non-instrumented后外侧脊柱融合术无论是人类还是猪的动物模型。由于局部抗结核抗生素治疗的效果目前尚不清楚，因此对体外人类应用不安全，我们的文献综述旨在评估目前的知识状况，即将块状自体骨移植物和陶瓷骨移植物的替代品，即磷酸钙糊状物，浸透单一等效体重调整口服剂量的利福平和异烟肼，会产生什么影响。猪动物模型后外侧脊柱融合率的研究。我们希望在这篇文献综述之后，使用猪模型进行体外动物研究，如果安全且证明有益，可以扩展到符合手术干预标准的脊柱结核患者的体外人体模型。

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引用次数: 0