Clinical efficacy of CT-guided percutaneous huge iliopsoas abscesses drainage combined with posterior approach surgery for the management of dorsal and lumbar spinal tuberculosis in adults

摘要

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 ± 141.3 mL, operation time was 174.8 ±15.7 minutes. Kyphotic angle improved from 36.6 ± 10.0° preoperatively to8.1±1.8° post-operatively 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 varing 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 iliopsoas abscesses in adults.