Spondilitis Tuberkulosa Cervical
Abstrak <br />Spondilitis tuberkulosa servikalis adalah penyakit yang cukup jarang dijumpai, hanya berkisar 2-3% dari<br />seluruh kasus spondilitis tuberkulosa. Gambaran klinis sangat bervariasi, mulai dari gejala ringan dan tidak spesifik<br />hingga komplikasi neurologis yang be...
Saved in:
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Faculty of Medicine at Universitas Andalas
2015-05-01
|
| Series: | Jurnal Kesehatan Andalas |
| Online Access: | http://jurnal.fk.unand.ac.id/index.php/jka/article/view/312 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | Abstrak <br />Spondilitis tuberkulosa servikalis adalah penyakit yang cukup jarang dijumpai, hanya berkisar 2-3% dari<br />seluruh kasus spondilitis tuberkulosa. Gambaran klinis sangat bervariasi, mulai dari gejala ringan dan tidak spesifik<br />hingga komplikasi neurologis yang berat. Seorang wanita berusia 29 tahun datang dengan keluhan lemah keempat<br />anggota gerak yang semakin memberat dalam 10 hari terakhir yang didahului oleh nyeri leher yang menjalar ke bahu<br />dan lengan sejak 6 bulan sebelumnya. Nyeri awalnya dirasakan sebagai keterbatasan gerakan leher saat menoleh<br />kesamping kiri dan kanan serta menundukkan kepala. Nyeri dirasakan semakin berat dengan pergerakan dan<br />berkurang jika istirahat. Pasien mengalami penurunan berat badan sejak 2 bulan terakhir. Tidak dijumpai riwayat batuk<br />atau nyeri dada. Pemeriksaan neurologis menunjukkan kelemahan pada keempat ekstremitas. Hasil laboratorium<br />ditemukan peningkatan Laju Endap Darah (LED). Rontgen foto toraks dalam batas normal. Roentgen foto cervical<br />menunjukkan destruksi setinggi C5. MRI cervical menunjukkan destruksi pada korpus C5-6 dengan penyempitan pada<br />discus intervertebrae C5-6 disertai dengan massa/abses paravertebral dengan penekanan ke posterior. MRI Thorakal<br />tampak destruksi corpus verebre T4,5 dengan diskus intervertebralis yang menyempit. Sugestif suatu spondilitis<br />tuberkulosa. Pasien dilakukan tindakan pembedahan anterior corpectomi melalui microscopic surgery dengan graft<br />dari iliac sinistra, serta insersi anterior plate 1 level. Hasil pemeriksaan patologi anatomi menunjukkan spodilitis TBC<br />kaseosa. Pada spondilitis vertebre T4,5 dilakukan laminectomi, debridement costotrasversektomi, dan stabilisasi<br />dengan pedicle screw T2, T3, dan T5. Pasien diterapi dengan obat antituberkulosis. Keadaan pasien saat ini, pasien<br />sudah bisa beraktifitas normal dengan motorik dan sensorik baik. Spondilitis tuberkulosa merupakan bentuk<br />tuberkulosa tulang yang paling sering dijumpai. Spondilitis tuberkulosa cervical berkisar 2-3% kasus spondilitis<br />tuberkulosa. Keterlibatan spinal biasanya merupakan akibat dari penyebaran hema<br />Kata kunci: spondilitis TB, cervical, pembedahan<br /> <br />Abstract <br />Cervical tuberculous spondylitis is a fairly rare disease, only about 2-3% of all cases of tuberculous<br />spondylitis. The clinical features vary widely, ranging from mild and non-specific symptoms until the fatal neurological<br />complications. A 29-year-old woman came with a complaint weakness of the four limbs become heavy in the last 10<br />days, were preceded by neck pain that radiates to the shoulders and arms since 6 months earlier. Pain was initially<br />perceived as a limitation of neck movement when turned to the left and right side, and bowed his head. Perceived pain<br />exacerbated by movement and reduced if the rest. Patients lost weight since the last 2 months. Found no history of<br />cough or chest pain. Neurologic examination showed weakness in four extremities. Laboratory results found increased<br />Erythrocyte Sedimentation Rate (ESR). X-ray radiographic normal. Cervical x-ray photograph shows destruction as<br />high as C5. MRI shows destruction in the corpus C5-6 with narrowing at C5-6 intervertebre disc accompanied by<br />paravertebral abscess with emphasis to the posterior. Found destruction corpus verebre T 4.5 with intervertebral disc<br />narrowing. Suggestive of a tuberculous spondylitis. At 5.6 C spondylitis vertebre anterior corpectomi following surgery,<br />microsurgery with iliac graft, and insertion one level anterior plate. Anatomical Pathology examination showed<br />caseating tuberculosis spodilitis. At T 4.5 vertebre spondylitis done laminectomi, costotrasversektomi debridement, and<br />stabilization with pedicle screw T2, T3, and T5. Patients also treated with anti-tuberculosis drugs. Present status,<br />patient is able to perform daily activity with sensoric and motoric good. Tuberculous Spondylitis is the most common form of tuberculosis that affect the bone. Cervical Tuberculous spondylitis ranges from 2-3% of cases of tuberculous<br />spondylitis. Spinal involvement is usually the result of hematogenous spread ekstraspinal lesions. Diagnosis is based<br />on history, clinical and radiological feature. Treatment consists of antituberculosis drug with or without surgical<br />intervention. The patient treat surgical intervention and anti-tuberculosis drug. Present status, patient is able to perform<br />daily activity with sensoric and motoric good.<br />Keywords:spondilitis TB, cervical, Surgery<br /> |
|---|---|
| ISSN: | 2301-7406 |