Computed Tomography–Guided Catheterization Drainage to Cure Spinal Tuberculosis With Individualized Chemotherapy

Abstract

The goal of this study was to investigate the effect of individualized chemotherapy delivered via percutaneous catheter drainage on paravertebral abscesses in spinal tuberculosis (TB). Data from 48 patients with spinal TB with paravertebral abscesses who received individualized chemotherapy via computed tomography-guided catheterization between 2009 and 2012 were retrospectively analyzed. The paravertebral abscesses affected the thoracic vertebra (n=12), the lumbar spine (n=20), the thoracolumbar vertebra (n=10), and the lumbosacral (n=6). All patients achieved clinical healing with no recurrence. Erythrocyte sedimentation rate and visual analog scale scores decreased significantly by the endpoint of follow-up. Although C-reactive protein values increased slightly right after treatment, they were also significantly lower at last follow-up. The kyphotic angle and Oswestry Disability Index values also exhibited significant decreases. No neurologic function impairment was reported. Computed tomography-guided catheterization for continuous administration of individualized chemotherapy was a safe and effective treatment for spinal TB with paravertebral abscesses in the cohort examined, and thus, it warrants further study. [Orthopedics. 2017; 40(3):e443-e449.].

Comparative efficacy of traditional conservative treatment and CT-guided local chemotherapy for mild spinal tuberculosis

“…ESR, VAS, kyphotic angle and oswestry disability index values decreased significantly. The CT guided drainage had been proven to be a safe and effective treatment for spinal tuberculosis with paravertebral abscesses [ 29 ]. In other anatomical regions, CT-guided percutaneous and drainage treatment was confirmed an efficient and attractive chose in the treatment of psoas abscesses to alternative the open surgical drainage, even multilocular pelvic and gluteal tuberculous abscesses [ 30 , 31 ], which was an easy, safe and effective treatment of the thoracic and lumbar spinal tuberculosis with flow injection abscess, even in children [ 32 , 33 ].…”

Posterior-only vs. combined posterior-anterior approaches in treating lumbar and lumbosacral spinal tuberculosis: a retrospective study with minimum 7-year follow-up

“…It was not applicable in cases with large multi-segment paravertebral abscesses or huge ilio-psoas abscesses, where an anterior debridement is necessary. In recent years, CT-guided percutaneous abscesses drainage and focal catheter infusion have been introduced as a new approach in the management of STB abscesses [36,37]. In this study, a case with postoperative abscess formation in group A was successfully treated via this method, which may be a safe and effective way in adjuvant therapy combined with posterior approach [38,39].…”