D X Zou1, J L Zhou2, X X Zhou3, X B Jiang4. 1. Department of orthopaedics, Beijing Chao-Yang hospital, Capital medical university, No. 8 Workers' Stadium South Road, Chaoyang District, 100020 Beijing, China; Department of orthopaedics, Yantai Yantaishan hospital, No. 94 Jie Fang Road, Zhifu District, 264000 Yantai, China. 2. Department of orthopaedics, Beijing Chao-Yang hospital, Capital medical university, No. 8 Workers' Stadium South Road, Chaoyang District, 100020 Beijing, China. Electronic address: zhoujunlinmed@163.com. 3. Department of orthopaedics, Beijing Chao-Yang hospital, Capital medical university, No. 8 Workers' Stadium South Road, Chaoyang District, 100020 Beijing, China. 4. Department of equipment, Yantai Yuhuangding hospital, No. 20 Yu Dong Road, Zhifu District, 264000 Yantai, China. Electronic address: 61647741@qq.com.
Abstract
PURPOSE: To evaluate the clinical efficacy of CT-guided percutaneous huge ilio-psoas abscesses drainage combined with posterior approach surgery for the management of dorsal and lumbar spinal tuberculosis in 16 adult cases. METHODS: Between January 2006 and June 2013, a total of 16 dorsal and lumbar spinal tuberculosis patients with huge ilio-psoas abscesses underwent two-stage CT-guided percutaneous abscesses drainage and posterior debridement, decompression, intervertebral fusion and instrumentation. Standard quadruple antituberculous chemotherapy was performed both before and after surgery. RESULT: The average follow-up period was 26.7 months (range: 18-38 months). There is no severe complication and relapse of spinal tuberculosis. The blood loss was 921.0±141.3mL, operation time was 174.8±15.7minutes. Kyphotic angle improved from 36.6±10.0° preoperatively to 8.1±1.8° postoperatively with 2.2±1.5° loss of correction at final follow-up. The solid bone fusion was achieved in all cases at average 6.6±2.2 months after surgery. Neurologic deficits were recovered in varying degrees except 4 cases remained the same. The postoperative quality of life significantly improved. The Oswestry Disability Index (ODI) decreased from 32.8±10.6 preoperatively to 14.4±7.9 at the final follow-up. CONCLUSION: CT-guided percutaneous drainage combined with posterior approach surgery was proved to be safe and effective for the management of dorsal and lumbar spinal tuberculosis with huge ilio-psoas abscesses in adults. LEVEL OF STUDY: Level IV, retrospective.
PURPOSE: To evaluate the clinical efficacy of CT-guided percutaneous huge ilio-psoas abscesses drainage combined with posterior approach surgery for the management of dorsal and lumbar spinal tuberculosis in 16 adult cases. METHODS: Between January 2006 and June 2013, a total of 16 dorsal and lumbar spinal tuberculosispatients with huge ilio-psoas abscesses underwent two-stage CT-guided percutaneous abscesses drainage and posterior debridement, decompression, intervertebral fusion and instrumentation. Standard quadruple antituberculous chemotherapy was performed both before and after surgery. RESULT: The average follow-up period was 26.7 months (range: 18-38 months). There is no severe complication and relapse of spinal tuberculosis. The blood loss was 921.0±141.3mL, operation time was 174.8±15.7minutes. Kyphotic angle improved from 36.6±10.0° preoperatively to 8.1±1.8° postoperatively with 2.2±1.5° loss of correction at final follow-up. The solid bone fusion was achieved in all cases at average 6.6±2.2 months after surgery. Neurologic deficits were recovered in varying degrees except 4 cases remained the same. The postoperative quality of life significantly improved. The Oswestry Disability Index (ODI) decreased from 32.8±10.6 preoperatively to 14.4±7.9 at the final follow-up. CONCLUSION: CT-guided percutaneous drainage combined with posterior approach surgery was proved to be safe and effective for the management of dorsal and lumbar spinal tuberculosis with huge ilio-psoas abscesses in adults. LEVEL OF STUDY: Level IV, retrospective.