Extensive thoracolumbar spinal tuberculosis treated with two-stage surgery using a minimally invasive posterior instrumentation

2010 ◽  
Vol 21 (6) ◽  
pp. 407-409 ◽  
Author(s):  
Satoshi Kato ◽  
Norio Kawahara ◽  
Hideki Murakami ◽  
Satoru Demura ◽  
Katsuhito Yoshioka ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Posterior Instrumentation ◽  
Spinal Tuberculosis ◽  
Two Stage ◽  
Thoracolumbar Spinal Tuberculosis

scholarly journals Surgical management of spinal tuberculosis with a two-stage posterior instrumentation with bridging: a case report

2021 ◽  
Vol 2021 (9) ◽  
Author(s):  
Faisal Mohammedsaleh Konbaz ◽  
Suhail Saad Alassiri ◽  
Sami Ibrahim Al Eissa ◽  
Majed Salah Abaalkhail ◽  
Hassan Nezar Khdary ◽  
...  
Keyword(s):  
Case Report ◽  
Antibiotic Therapy ◽  
Bone Healing ◽  
Surgical Procedure ◽  
Posterior Instrumentation ◽  
Spinal Tuberculosis ◽  
Two Stage ◽  
Posterior Decompression ◽  
Bridging Technique ◽  
Extrapulmonary Manifestation

Abstract Tuberculosis (TB) affects millions of people every year. Spinal TB is a common extrapulmonary manifestation of the disease. Spinal TB can be devastating and carries an unfortunate outcome. Herein, we present an atypical spinal TB that was treated initially based on intraoperative cultures with posterior decompression and instrumentation of T11–L3 with directed antibiotic therapy. Recurrence of the lesion and failure of instrumentation necessitated further investigation and intervention 1 year later. Using a two-stage surgical procedure leaving the infected spine to heal first with directed anti-TB medications. The patient was managed using posterior instrumentation with bridging from T5 to the pelvis, spanning the destructed area and utilizing a bridging technique with multiple rod constructs across the infected spine. Here, we present the benefit of using the bridging technique to promote bone healing and achieve a solid fixation.

A Rare Case of Spinal Leprosy Mimicking Spinal Tuberculosis

2019 ◽  
pp. 33
Author(s):  
K Thuraikumar ◽  
V Naveen ◽  
Mustaqim A ◽  
Arieff AA ◽  
K Shri ◽  
...  
Keyword(s):  
Back Pain ◽  
Soft Tissue ◽  
Histopathological Examination ◽  
Posterior Instrumentation ◽  
Spinal Tuberculosis ◽  
Previous History ◽  
Skin Lesions ◽  
Titanium Implants ◽  
Paravertebral Abscess ◽  
History Of

Introduction: Spinal tuberculosis is the most common manifestation of extrapulmonar y tuberculosis. A combination of leprosy and tuberculosis is a rare entity.Case report: A 44-year-old male patient working as a laborer presented to our hospital with complaints of severe back pain and swelling over the back, difficulty in walking, associated with constitutional symptoms. On admission, he was febrile and had leukocytosis. Initial spine X-ray showed end plate destruction and increase in soft tissue shadow at the level of T8-T9. CT spine revealed thoracic paravertebral collection extending from T7 to T9 levels, suggest ive of tuberculous spondylitis with cold abscess. Patient refused a transpedicular biopsy and was started on anti-tubercular therapy. Two weeks after commencement of treatment, he developed worsening back pain and weakness of the lower extremities. MRI spine showed a paravertebral abscess and posterior soft tissue edema involving level of T7 to T11. Patient underwent a posterior decompression, debridement and posterior instrumentation. He was discharged well, there was improvement of his lower limb power. Upon clinic review, he complained of multiple hyperpigmented, painless, nonpruritic skin lesions over the trunk and back. No previous history of eczema, psoriasis and Tinea corporis. Given the history of allergy, initial impression was hypersensitivity reaction towards the titanium implants, and he was started on anti-histamines. However, there was no improvements seen. Histopathological examination of skin lesions revealed presence of granuloma within the dermis layer, composed of epitheloid, histiocytes, lymphocytes and plasma cells. Wade-Fite stain for Mycobacterium leprae is positive. Slit skin smear shows multibacillary leprosy. Patient was started on multidrug therapy (rifampicin, clofazimine and dapsone) for 1 year. He has recovered well.International Journal of Human and Health Sciences Supplementary Issue: 2019 Page: 33

scholarly journals Clinical Outcome of Single-Stage Decompression and Posterior Stabilization in Thoracolumbar Spinal Tuberculosis

2021 ◽  
Author(s):  
Patro Kumar Susanta ◽  
Nayak Biswaranjan ◽  
Krishnamurthy Holeppagol Balappa ◽  
Arun Kumar ◽  
Debabrata Biswal ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Spinal Injury ◽  
Spinal Tuberculosis ◽  
Thoracolumbar Spine ◽  
Single Stage ◽  
Posterior Stabilization ◽  
Surgical Interventions ◽  
Antitubercular Drugs ◽  
Impairment Score ◽  
Thoracolumbar Spinal Tuberculosis

Abstract Background Thoracolumbar spine constitutes the most common site for spinal tuberculosis. Though the treatment of spinal tuberculosis is antitubercular drugs initially, the patient with neurologic weakness warrants definitive surgical procedure of decompression and stabilization. Even though many investigators have reported favorable results with anterior decompression and stabilization surgery, due to the increased morbidity and complications, the posterior-only approach with decompression and stabilization has evolved as the operation of choice in recent time. Methods All patients aged between 18 and 70 years with clinically and radiologically proven symptomatic thoracolumbar spinal tuberculosis who failed with conservative treatment for 4 weeks or developed neurologic weakness between the treatments are included in this study. All patients were offered decompression and posterior stabilization with transpedicular screws and rods after explaining the above procedure. Clinical outcome was measured by modified Frankel grading; AIS (American Spinal Injury Association impairment score) grade impairment score; and pain assessment done with visual analog scale (VAS) pre- and postoperatively and at 3, 6, and 9 months of interval. Results The postoperative pain relief, neurologic improvement as per modified Frankel grade, AIS grade, and improvement in erythrocyte sedimentation rate and C-reactive protein were significant as compared with the preoperative status. The surgical interventions thus prove to have adequate relief to the patient and arresting the disease progression. The surgical outcome has very minimal intra- and postoperative complications. Conclusion Single-stage decompression and posterior stabilization in thoracolumbar spinal tuberculosis is safe, effective, and results in good clinical outcome. The advantages of surgery include thorough debridement, decompression, and achievement of spinal stabilization.

scholarly journals NONCOMPLICATED UNSTABLE SPINE INJURIES IN CHILDREN

2005 ◽  
pp. 008-012 ◽  
Author(s):  
Eduard Vladimirovich Ulrikh ◽  
Sergey Valentinivich Vissarionov ◽  
Aleksandr Yuryevich Mushkin
Keyword(s):  
Surgical Treatment ◽  
Posterior Instrumentation ◽  
Spinal Injuries ◽  
Anterior Decompression ◽  
Two Stage ◽  
Spinal Stabilization ◽  
Spine Injuries ◽  
Group A ◽  
Bone Autograft

Thirty-four patients aged from 3 to 17 years were operated on for noncomplicated unstable injuries of the spine. The operation was performed within the next few hours or days after trauma in 15 cases and significantly later (in 2 to 6 months) in 19 cases. In the first group the surgery included indirect posterior instrumental reduction and stabilization of the spine. In the second group a two-stage surgery was performed simultaneously. The first stage included anterior decompression and stabilization, and the second – posterior instrumentation. In both groups the posterior fusion with bone autograft was done. The post-op follow-up was 5 years. The correction of deformity, spinal stabilization and pain arrest were achieved in all cases. The surgical treatment of unstable noncomplicated spinal injuries in children must be conducted by emergency indications within the first hours and days after trauma.

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