Document Detail


Percutaneous management of complications of tuberculous spondylodiscitis: short- to medium-term results.
MedLine Citation:
PMID:  19554419     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Psoas abscesses are the most frequent complication of tuberculosis with skeletal involvement. The aim of this paper is to report our experience with the systematic application of percutaneous drainage to tuberculous psoas abscesses. MATERIALS AND METHODS: Between January 1997 and December 2005, 23 patients (14 men and nine women; age range 21-48 years), after a previous study with computed tomography (CT) and/or magnetic resonance (MR) imaging, underwent percutaneous drainage of a tuberculous fluid collection in the psoas muscles. Follow-up consisted of monthly clinical and laboratory assessment, and plain chest radiography and spinal CT every 6-12 months. RESULTS: Spondylodiscitis involved the thoracolumbar spine. Fluid collections were bilateral in 14 cases and communicating in ten of these. Maximum transverse diameter was 7 cm, whereas longitudinal diameter was 14 cm. Placement of the drainage catheter was successful in all cases, and the catheter was left in place for 5-36 (mean 18.4) days. Symptom regression occurred immediately after drainage of the fluid collection. The drainage procedure was curative in 100% of cases. Dislodgement of the drainage catheter occurred in two cases as a result of excessive traction during dressing removal. CONCLUSIONS: A serious complication of bone tuberculosis, psoas abscesses, can be effectively treated by percutaneous drainage, leading to immediate pain resolution. The drainage catheter requires daily monitoring to identify when it can be safely removed without risk of recurrence.
Authors:
S Pieri; P Agresti; A M Altieri; P Ialongo; A Cortese; M G Alma; L de' Medici
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Publication Detail:
Type:  Journal Article     Date:  2009-06-25
Journal Detail:
Title:  La Radiologia medica     Volume:  114     ISSN:  1826-6983     ISO Abbreviation:  Radiol Med     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-10-02     Completed Date:  2009-12-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0177625     Medline TA:  Radiol Med     Country:  Italy    
Other Details:
Languages:  eng; ita     Pagination:  984-95     Citation Subset:  IM    
Affiliation:
Radiologia Vascolare ed Interventistica, Rome, Italy. stepieri@excite.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Contrast Media
Discitis / complications*
Drainage / methods*
Female
Gadolinium DTPA / diagnostic use
Humans
Lumbar Vertebrae
Magnetic Resonance Imaging, Interventional
Male
Middle Aged
Psoas Abscess / etiology*,  therapy*
Radiography, Interventional
Thoracic Vertebrae
Tomography, X-Ray Computed
Treatment Outcome
Triiodobenzoic Acids / diagnostic use
Tuberculosis, Osteoarticular / complications*
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Triiodobenzoic Acids; 80529-93-7/Gadolinium DTPA; 87771-40-2/ioversol

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