ABSTRACT
The purpose of this study is to describe the outcome of surgical treatment for tuberculous spondylitis in 29 patients. These patients were part of an overall series of 67 cases of tuberculous spondylitis treated at the Traumatology and Orthopedic Department of the Yalgado-Ouedraogo National Hospital Center (YONHC) in Ouagadougou, Burkina Faso. Almost 90% of the 29 patients that underwent surgical treatment of tuberculous spondylitis associated with neurological manifestations were from poor rural areas. Mean age was 48 years and most patients were men. The procedure consisted of corporectomy via the anterolateral approach. Resection of variable extent was followed by replacement with forced insertion of a fibular graft. Intraoperative complications included non-fatal cardiovascular arrest (n = 1), inadvertent incision of the peritoneum (n = 3), and technical error in exposure of the damaged vertebrae (n = 1). Postoperative complications included emphysema (n = 2), massive pleurisy (n = 1), chylothorax (n = 1), pneumonia (n = 1), worsening of neurological manifestations (n = 1), and subacute peritonitis (n = 1). Surgical mortality was 10.3% (n = 3). Bone fusion was achieved in all patients. Functional recovery ranged from 50 to 60% after surgical treatment, which is comparable to rates in previous African reports. Choice of therapeutic modalities must take into account cost within the national health care context, duration of hospitalization and invasiveness. Surgical treatment should be used only when absolutely necessary.
Subject(s)
Nervous System Diseases/etiology , Thoracic Vertebrae , Tuberculosis, Spinal/complications , Tuberculosis, Spinal/surgery , Adult , Aged , Female , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
The authors report one case of a bilateral atraumatic circumscribed myositis ossificans (C.M.O.) developed from the triceps muscles with major equinism, in a 15 years old girl. One side presented a current tumor, the other was seen at the first episode. The authors obtained a good functional result after surgical treatment and advocate this treatment.
Subject(s)
Leg , Myositis Ossificans/diagnosis , Adolescent , Female , Humans , Myositis Ossificans/diagnostic imaging , Myositis Ossificans/pathology , Myositis Ossificans/surgery , RadiographyABSTRACT
A partir du depistage systematique aux ELISA 1;2 et mixte chez les malades d'orthopedie presentant une affection opportuniste; les auteurs rapportent 33 cas de seropositifs sur 2185 malades hospitalise du 1er janvier 1989 au 23 fevrier 1995. Seuls 16 avaient un dossier complet et un suivi regulier. L'etude des 16 dossiers a permis de retrouver des resultats epidemiologiques corroborant avec ceux de la litterature; a savoir : une atteinte plus frequente des hommes (sex ratio = 4;3); de la population citadine (75 pour cent des cas); l'age moyen de seroprevalence = 35;6 ans avec des pics entre 10 -19 ans et 30-39 ans; par contre; ils trouvent une atteinte plus elevee chez les personnes sans emploi. Parmi les pathologies osteo-articulaires repertoriees; ils retrouvent une association frequente des infections osteo-articulaires (osteo-arthrite de la hanche; mal de pott; osteomyelite chronique a infection VIH : de ce constat ils proposent la systematisation de la serologie VIH devant toutes ces infections osseuses. Ils considerent comme facteurs de risques le nombre eleve de seropositifs (33/2185 cas =0;15) par rapport aux donnees de la litterature; la manipulation de ces seropositfs par une equipe soignante travaillant dans une ambiance et un contexte favorable a la contamination par le VIH. Ils suggerent des recommandations dont l'application permettrait de minimiser ces risques
