ABSTRACT
OBJECTIVE@#To investigate the effect of preoperative percutaneous drainage in lumbar tuberculosis with psoas abscess, through compare the clinical efficacy of two different methods.@*METHODS@#Thirty-six patients with lumbar tuberculosis complicated with psoas abscess in corresponding with the inclusion criteria were admitted in Zhejiang Province Traditional Chinese Medicine Hospital from January 2015 to January 2017. The patients were divided into group A and group B according to the different therapeutic methods. All patients were given the standard anti tuberculosis treatment, and percutaneous catheter drainage was used in group A after admission immediately for psoas abscess before operation, while group B with no special treatment. At 3 weeks after anti tuberculosis treatment, 2 patients were excluded in group B, which had to postpone operation because of no reduction in erythrocyte sedimentation rate(ESR) and C reactive protein(CRP). Finally 34 patients were enrolled in this study. There were 18 cases in group A, including 10 males and 8 females, aged from 24 to 73 years old with an average of(42.5±10.2) years. There were 16 cases in group B, including 9 males and 7 females, aged from 23 to 75 years old with an average of(42.3±9.8) years. All patients were treated with posterior pedicle screw fixation, anterior debridement and bone graft fusion. Anterior surgery bleeding volume, operation time, anterior incision length, postoperative anus exhaust time, VAS score, Cobb angle, ESR, CRP changes and postoperative sinus formation were compared between two groups.@*RESULTS@#All patients were followed up for 6 to 21 months with an average of 13 months. At the last follow-up, no mixed infection, tuberculosis recurrence, pedicle screw loosening and nail withdrawal were found. The average operative time, anterior surgery bleeding volume and anterior incision length of group A were less than that of group B(0.05). There was 1 case sinus formation in group A and 5 cases in group B, there was significant difference in sinus formation rate between two groups (0.05). Spinal cord nerve injury was obvious improved after operation, but there was no significant difference between two groups.@*CONCLUSIONS@#Preoperative percutaneous catheter drainage is a safe and feasible method for the treatment of lumbar tuberculosis with psoas abscess. It can increase the effect of anti tuberculosis before operation, reduce the surgical trauma and reduce the incidence of postoperative complications. It can be recommended in clinical application.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Drainage , Feasibility Studies , Lumbar Vertebrae , Psoas Abscess , Therapeutics , Spinal Fusion , Thoracic Vertebrae , Treatment Outcome , Tuberculosis, SpinalABSTRACT
@#ObjectiveTo investigate the effect of operation treating spinal multi-level tuberculosis.Methods45 patients with multi-level spine tuberculosis were treated with debridement completely and anterior or lateral-anterior intervertebrae autograft. Of them, 5 patients added to anterior instrumentation.Results45 patients had been followed up for 12 to 40 months.The back pain of 40 cases were relieved within 5 weeks after operation, erythrocyte sedimentation rate decreased 3 weeks after operation. 38 patients who involved in kyphosis decreased their kyphosis mostly and only one patient lost 3 degrees in follow-up.15 patients who involved in neurological deficits improved one or two grades (Frankel). Grafts fused in 44 patients and there were no recurrent in follow-up.Conclusions Operative treatment is efficacious to multi-level body spine tuberculosis.
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Objective To determine the potential value of imaging for spinal tuberculosis. Methods 180 patients proved as spinal tuberculosis by operation or clinical follow who underwent X-ray film, CT and MRI were reviewed. They were classified A, B or C in term of imaging and clinical symptom. A was the normal of X- ray film and positive of CT or MRI. B was positive of X-ray film, CT and MRI. C was with the neurological symptoms. Results 40 patients ( 40/180 ) were categorized as A . They had short duration (
ABSTRACT
Posterior transpedicle instrumental fixation and anterior arthrodesis were performed in 34 patients with spinal tuberculosis.Antituberculous chemotherapy was qiven for nine months postoperatively, and the surgical outcomes were followed up for three to five years.All the patients were cured and there was no recurrence two years after stopping chemotherapy.Tubercular kyphosis was 24?preoperatively and 9?postoperatively, and deformity correction was maintained during the follow up period.Interbody fusion was achieved in all the patients after surgery,four months for one segment fusion, six months for two segments fusion.It is concluded that posterior instrumental stabilization and anterior interbody fusion are helpful in providing rigid stabilization,correcting or preventing progression of kyphosis, and that transpedicle instrumental fixation can accelerate interbody fusion, shorten chemotherapy course and improve its cucative ratio.