scholarly journals Posterior-only debridement, internal fixation, and interbody fusion using titanium mesh in the surgical treatment of thoracolumbar tuberculosis with spinal epidural abscess: a minimum 5-year follow-up

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Qile Gao ◽  
Chaofei Han ◽  
Manini Daudi Romani ◽  
Chaofeng Guo ◽  
Mingxing Tang ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Internal Fixation ◽  
Interbody Fusion ◽  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Titanium Mesh ◽  
Neurological Score ◽  
The Mean ◽  
Spinal Epidural

Abstract Objective To investigate the clinical efficacy and feasibility of posterior-only debridement, internal fixation, and interbody fusion using titanium mesh in the surgical treatment of thoracolumbar tuberculosis (TB) with spinal epidural abscess. Methods From January 2008 to January 2014, a total of 45 patients (27 male and 18 female) were reviewed. The patients were diagnosed with thoracolumbar TB with spinal epidural abscess. The patients underwent posterior-only debridement, internal fixation, and interbody fusion using titanium mesh. Hence, we assessed the intraoperative and postoperative complications, disease recurrences, kyphosis deformity correction, and neurological improvement following the American Spinal Injury Association (ASIA). We used SPSS 22.0 for the statistical analyses. An independent Student’s t-test was used for the analysis of preoperative and postoperative continuous variables. The value of P (P < 0.05) was considered statistically significant. Results The mean age of patients was 37.76 ± 10.94 years (17–59 years). The mean follow-up time was 82.76 ± 12.56 months (60–128 months). The mean kyphosis Cobb angle preoperative was 29.36 ± 13.29° (5–55°) and postoperative was 3.58 ± 5.44° (− 6–13°), given the value of P (P < 0.001). According to the neurological score by the ASIA scale, there were 3 cases of grade B, 11 cases of grade C, 16 cases of grade D, and 15 cases of grade E preoperatively. The neurological score improved by 1 ~ 2 grades. All patients achieved pain relief and the VAS score significantly reduced at the last follow-up (P<0.05). While 1 patient had cerebrospinal fluid leakage, 1 had a neurological complication, 1 had delayed surgical wound healing, and 1 had a disease recurrence. No pseudoarthrosis or implant failure occurred in our patients. All patients achieved solid bone graft fusion. Conclusion For thoracolumbar TB patients with spinal epidural abscess, posterior-only debridement, internal fixation, and interbody fusion using titanium mesh are safe and effective surgical treatments.

scholarly journals Posterior-only Debridement, Internal Fixation, and Interbody Fusion Using Titanium Mesh in the Surgical Treatment of Thoracolumbar Tuberculosis With Spinal Epidural Abscess: A Minimum 5-year Follow-up

2021 ◽  
Author(s):  
Qile Gao ◽  
Chaofei Han ◽  
Manini Daudi Romani ◽  
Chaofeng Guo ◽  
Mingxing Tang ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Internal Fixation ◽  
Interbody Fusion ◽  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Titanium Mesh ◽  
Neurological Score ◽  
The Mean ◽  
Spinal Epidural

Abstract Objective: To investigate the clinical efficacy and feasibility of posterior-only debridement, internal fixation, and interbody fusion using titanium mesh in the surgical treatment of thoracolumbar tuberculosis (TB) with spinal epidural abscess.Methods: From January 2008 to January 2014, a total of 45 patients (27 male and 18 female) were reviewed. The patients were diagnosed with thoracolumbar TB with spinal epidural abscess. The patients underwent posterior-only debridement, internal fixation, and interbody fusion using titanium mesh. Hence, we assessed the intraoperative and postoperative complications, disease recurrences, kyphosis deformity correction, and neurological improvement following the American Spinal Injury Association (ASIA). We used SPSS 22.0 for the statistical analyses. An independent Student’s t-test was used for the analysis of preoperative and postoperative continuous variables. The value of P (P<0.05) was considered statistically significant.Results: The mean age of patients was 37.76 ±10.94 years (17–59 years). The mean follow-up time was 82.76 ±12.56 months (60–128 months). The mean kyphosis Cobb angle preoperative was 29.36 ±13.29° (5–55°) and postoperative was 3.58 ±5.44° (–6–13°), given the value of P (P<0.001). According to the neurological score by the ASIA scale, there were 3 cases of grade B, 11 cases of grade C, 16 cases of grade D, and 15 cases of grade E preoperatively. The neurological score improved by 1~2 grades. All patients achieved pain relief and the VAS score significantly reduced at the last follow-up (P＜0.05). While 1 patient had cerebrospinal fluid leakage, 1 had a neurological complication, 1 had delayed surgical wound healing, and 1 had a disease recurrence. No pseudoarthrosis or implant failure occurred in our patients. All patients achieved solid bone graft fusion.Conclusion: For thoracolumbar TB patients with spinal epidural abscess, posterior-only debridement, internal fixation, and interbody fusion using titanium mesh are safe and effective surgical treatments.*As a note, Qile Gao and Chaofei Han are Co-First authors.

scholarly journals Diabetes mellitus and spinal epidural abscess: clinical or surgical treatment?

2011 ◽  
Vol 55 (9) ◽  
pp. 720-722 ◽  
Author(s):  
João S. Felício ◽  
Carlliane Lins P. Martins ◽  
Bernardo Liberman
Keyword(s):  
Diabetes Mellitus ◽  
Surgical Treatment ◽  
Conservative Treatment ◽  
White Woman ◽  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Predisposing Factor ◽  
Uncommon Condition ◽  
Spinal Epidural

Spinal epidural abscess (SEA) is an uncommon condition and its most important predisposing factor is diabetes mellitus. Although the treatment of choice is prompt surgical abscess evacuation, followed by antibiotic therapy, successful conservative treatment of SEA has been reported in some cases. We describe a SEA case in a 23-year old white woman with diabetes for 14 years, who was successfully treated only with antibiotics, and achieved full recovery at the fourth month of follow-up.

Tuberculous spinal epidural abscess (case report and literature review)

MedAlliance ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 57-63
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Thoracic Spinal ◽  
Treat Ment ◽  
Tuberculous Abscess ◽  
Progressive Neurological Deficit ◽  
Spinal Epidural

Tuberculous spinal epidural abscess (SEA) is an uncom-mon pathology, which presents is only 2% of all SEA ca-ses. We report a rare cases of cervical-lumbar and thoracic spinal epidural tuberculous abscess occupying the spinal canal from C2–L3 and Th8–Th9 vertebrae with progressive neurological deficit. Clinical features, diagnostic and treat-ment challenges and follow-up results were presented

Spinal epidural abscess with gadolinium-enhanced MRI: serial follow-up studies and clinical correlations

1994 ◽  
Vol 36 (1) ◽  
pp. 44-48 ◽  
Author(s):  
N. Sadato ◽  
Y. Numaguchi ◽  
D. Rigamonti ◽  
T. Kodama ◽  
E. Nussbaum ◽  
...  
Keyword(s):  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Enhanced Mri ◽  
Follow Up Studies ◽  
Clinical Correlations ◽  
Spinal Epidural

scholarly journals Tuberculous lumbar spinal epidural abscess in a young adult (case report)

SICOT-J ◽  
2018 ◽  
Vol 4 ◽  
pp. 5
Author(s):  
Ghazwan Abdulla Hasan ◽  
Saif Mohammed Kani ◽  
Ahmed Alqatub
Keyword(s):  
Case Report ◽  
Lower Limb ◽  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Mri Scan ◽  
Limb Weakness ◽  
Lower Limb Weakness ◽  
Lumbar Spinal ◽  
Spinal Epidural

Introduction: Spinal Epidural abscess (SEA) is an uncommon pathology that needs an urgent intervention to decompress the pressure on the spinal epidural sac, cord, and roots. The authors report a rare case of a young adult with lumbar spinal epidural tuberculous abscess occupying the spinal canal from L2–L5 vertebrae with extesion to the posterior paraspinal muscles and presenting with bilateral progressive lower limb weakness.   Case report: A 42 years old male teacher presented with a 15-day history of progressive difficulty to walking and bilateral lower limb weakness associated with fever, malaise and later on urinary incontinence. A magnetic resonance imaging (MRI) scan revealed a paraspinal intermuscular abscess and an abscess occupying the spinal canal compressing the dural sac from L2–L4/5, without any signs of vertebral involvement. Surgery was done by a posterior midline incision. Pus was evacuated from multiple pockets through the paraspinal muscle layers. Laminectomy for L3/4, and hemilaminectomy for L2/3, and L4/5 were performed. Pus and bone specimens were negative for acid-fast bacilli. However, both histopathological studies and Polymerase Chain Reaction (PCR) testing confirmed the presence of tuberculosis (TB). The patient received TB antibiotics, and a follow-up MRI scan at 2 months showed complete evacuation of the abscess. However, signs of L5 spondylitis were evident. No further surgery was needed as there was no vertebral collapse or neural compression and the patient's clinical condition was improving. He had normal right lower limb power and sensation and grade 4+ motor power of the left lower limb. Bowels and bladder function was normal. Conclusion: Isolated tuberculous spinal epidural abscess is a rare disease and should be treated urgently with evacuation and decompression. Signs of spondylitis or spondylodiscitis may appear later and therefore long follow up is recommended in tuberculous cases presenting with an isolated epidural abscess.

Nocardia Spinal Epidural Abscess: 14-year Follow-up

Orthopedics ◽  
2012 ◽  
Author(s):  
Kristoffer R. West ◽  
Robert C. Mason ◽  
Mike Sun
Keyword(s):  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Spinal Epidural

Epidural Abscess

2016 ◽  
Author(s):  
David Mabey
Keyword(s):  
Back Pain ◽  
Surgical Treatment ◽  
Early Diagnosis ◽  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Surgical Drainage ◽  
Stable Patient ◽  
Common Presentation ◽  
Spinal Epidural

An epidural abscess is a collection of pus that has accumulated between the dura and the calvarium or spine. It is rare but can lead to severe neurologic dysfunction or death. There are two main subsets of epidural abscess: spinal epidural abscess (SEA) and intracranial epidural abscess (ICEA). Early diagnosis is key to minimizing complications. Back pain is the most common presentation of SEA, along with spinal tenderness. Treatment requires prolonged hospitalization, surgical drainage in most cases, and long-term antibiotics. Except in rare cases, patients with SEA and ICEA will require hospital admission. In the stable patient, antibiotics should be withheld until culture data can be obtained. If surgical treatment is not readily available, biopsy is often performed to obtain samples for culture before starting antibiotics.

scholarly journals Pneumorachis from the cervical to the sacral spinal canal with spinal epidural abscess by gas gangrene

2019 ◽  
Vol 27 (2) ◽  
pp. 230949901986007
Author(s):  
Tomoki Matsuo ◽  
Atsushi Tanji ◽  
Koichi Tateyama ◽  
Yuhei Yoda ◽  
Yusaku Kamata ◽  
...  
Keyword(s):  
Spinal Canal ◽  
Epidural Abscess ◽  
Rare Condition ◽  
Gas Gangrene ◽  
Neurological Deficits ◽  
Spinal Epidural Abscess ◽  
Laboratory Findings ◽  
Severe Diabetes ◽  
Spinal Epidural

We present a 70-year-old woman with severe diabetes mellitus, who experienced low back pain and left lower leg paralysis. Computed tomography showed air in the spinal canal from C4 to S5, and magnetic resonance imaging revealed an epidural abscess from Th11 to L1. Laboratory findings showed increases in inflammatory indicators and blood culture indicated the presence of Escherichia coli. The patient was treated conservatively with antibiotics. Neurological deficits and inflammatory data improved during the course. Follow-up imaging studies showed the disappearance of gas and epidural abscess. The existence of air in the spinal canal is a rare condition known as pneumorachis. To the best of our knowledge, such a long pneumorachis ranging from the cervical to the sacral spinal canal with epidural abscess caused by gas gangrene has not yet been described. We should therefore realize the possibility of epidural abscess produced by gas gangrene and treat it appropriately.

scholarly journals Spinal Epidural Infection

1979 ◽  
Vol 6 (3) ◽  
pp. 325-328 ◽  
Author(s):  
N.A. Russell ◽  
Richard Vaughan ◽  
T.P. Morley
Keyword(s):  
Surgical Treatment ◽  
Epidural Abscess ◽  
Correct Diagnosis ◽  
Spinal Epidural Abscess ◽  
Results Of Treatment ◽  
Mode Of Presentation ◽  
Complete Paralysis ◽  
Spinal Epidural

SUMMARY:Thirty cases of spinal epidural abscess are reviewed with particular emphasis on mode of presentation and results of treatment. In spite of repeated exhortations in the literature for earlier diagnosis, the results remain unsatisfactory because many patients have progressed to severe or complete paralysis before the correct diagnosis is made and surgical treatment carried out.

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