Two Cases of Surgical Treatment of Thoracic Tuberculous Spondylitis: Case Report

Tow surgically treated cases of thoracic tuberculous spondylitis with multievel involvement are presented. Radical debridement produced large deficit in the anterior structures and spinal instability. A reconstruction with mesh cylinder graft and combined anterior instrumentation surgery in one stage operation. Anterior Instrumentation provided immediate stability and protected against development of kyphotic deformity. There was no persistence or recurrence of infection after surgery. The average length of follow up was 24month including 12month, 18month course of chemotherapy.

Surgical Planning for Thoracolumar Spine Fracture

Many of the thoracolumbar spine fracture may be managed conservatively by postural reduction. But postural reduction alone cannot treat all the patient with thoracolumbar spine fracture properly. Recently, more patients with thoracolumbar spine fracture are managed surgically with the advance of surgical technique and instrument. Surgery may be performed by either anterior or posterior approach according to many factors. Generally initial management of patient with thoracolumbar spine fracture is conservative and surgery is delayed for spinal fusion, but early surgery with decompression of spinal cord and fusion of the vertebral body seems to be more proper in unstable fracture with compression of spinal cord by bony fragment and incomplete neurological deficit. Authors analyzed 52 cases of thoracolumbar spine fracture and made a proper management plan and proper surgical approach.

Primary Pituitary Abscess: Case Report

Pituitary abscess may be caused by direct extension of contiguous infections from purulent sphenoid sinusitis, meningitis or cavernous sinus thrombophlebitis. It also develop after craniotomy or transsphenoidal hypophysectomy. In some cases, it was associated with primary pituitary tumor or cyst which were vulnerable to infection because of impaired circulation, areas of necrosis or local immunological impairment. Primary pituitary abscess may also occur without any preceding infection. Since the clinical features, computed tomographic findings, and laboratory data of primary pituitary abscess were similar to pituitary tumor, preoperative diagnosis of pituitary abscess is difficult. Inhomogenous enhancement with central low density and focal bulge at the level of diaphragm was reported to be compatible with computed tomographic findings of pituitary abscess.