Cervical XXXX : a preliminary study of clinical diagnosis and management.

@entity1 @entity1688 @entity16 @entity3083 @entity51 @entity5221 @entity4048 @entity158 @entity426 @entity378
BACKGROUND: Cervical involvement in @entity3083 is rare; however delayed diagnosis and treatment may result in massive, irreversible @entity16 . The purpose of this study is to report on a strategy for clinical diagnosis and management of cervical @entity3083 . MATERIAL AND METHOD: Eighteen @entity1 (13 males and 5 females) during 1998-2013 were retrospectively reviewed at Chiang Mai University Hospital. The @entity1 had a mean age of 51.4 years (range 37-68 years). History, examination, radiographs, MRI and tissue sampling were used in diagnosis. Most of the @entity1 were given antituberculous therapy (ATT) and underwent surgical management. The mean follow-up period was 12.8 months. RESULTS: @entity5221 , @entity1688 , @entity426 and hand clumsiness were the predominant symptoms. Disc narrowing, endplate destruction andparaspinal soft tissue swelling were the prominent radiographic findings. MRI found Gadolinium enhancement of prevertebral soft tissue, T2 hypersignal of the intervertebral discs, intraosseous T2 hypersignal at the vertebral body, and disc fragmentation. Thirteen @entity1 underwent single-stage anterior debridement with fusion. Three @entity1 underwent posterior fusion alone. @entity4048 improved in all @entity1 . Nurick's disability index and fusion rate improved in 70% of the @entity1 after conservative and surgical treatment. CONCLUSION: Cervical @entity3083 should be suspected in endemic @entity1 with severe neck @entity158 and progressive @entity51 . Histopathology is the gold standard of @entity378 diagnosis. Anti- @entity378 drugs should be continued for at least 12 months. Radical anterior debridement and instrumented fusion has demonstrated favorable results. The posterior approach is an alternative treatment in @entity1 when the anterior approach cannot be performed or as part of second-stage surgery.
