A Case of Unusual Lung Abscess Induced by Psoas Abscess in Tuberculosis of the Spine / 대한정형외과학회잡지

ABSTRACT

A case of unusual lung abscess induced by psoas abscess in tuberculosis of the thoracolumbar spine complicated with complete spastic paraplegia is reported. Usually the tuberculous psoas abscess drains out along the fascia and ligament by it's own gravity. The common site of drainage of the tuberculous psoas abscess are the Petit triangle, the femoral triangle, the sciatic notch, the adductor region of the thigh and the lumbar region. In the reported case the left psoas abscess penetrated into the diaphragm and induced a lung abscess. This was confirmed by operation as no communication was inspected between the paravertebral abscess. The abscess was completely evacuated through thoracotomy and the tuberculous lesion in T-11,12 was operated by complete removal of focus and simultaneous anterior spinal fusion, another lesion in the lumbar spine was operated by radical operation three weeks after first operation. The paraplegia was recovered three months after first operation with satisfactory bony union and the patient was allowed to be up and about. A satisfactory result was obtained by radical ressection and anterior interbody fusiao of T-11,12 of the diseased vertebrae through the left extrapleural approach. This was followed by focal deberidement of right psoas abscess.