Case control studies of two kinds of method for the treatment of lumbar tuberculosis with psoas abscess
10.3969/j.issn.1003-0034.2016.01.008
- VernacularTitle:两种术式治疗腰椎结核伴腰大肌脓肿的病例对照研究
- Author:
Qi WANG
1
;
Ming HU
;
Zheng Yuan MA
;
Bo Xiao LUO
Author Information
1. 解放军总医院骨科
- Keywords:
Lumbar vertebrae;
Tuberculosis,spinal;
Psoas abscess;
Puncture;
Drainage
- From:
China Journal of Orthopaedics and Traumatology
2016;(1):33-37
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare two kinds of method for treating lumbar tuberculosis with psoas abscess ,to provide ref-erence for clinical reasonable select of therapy treatment. Methods:From January 2010 to January 2013,42 patients with lum-bar tuberculosis combined with psoas abscess with obvious surgical indications were enrolled ,including 24 males and 18 fe-males with an average age of (38.5±10.2) years old ranging from 21 to 63 years old. All patients were followed up for 18 to 24 months with an average of 20.9 months. Twenty two patients underwent posterior vertebral body lesions cleared ,bone graft fu-sion and internal fixation and percutaneous puncture catheter drainage for treatment of psoas major abscess as group A ,and twenty patients underwent one stage extraperitoneal approach to remove abscess ,posterior vertebral body lesions cleared ,bone graft fusion and internal fixation as group B. The operative time,loss of blood,length of hospital stay,clinical cure rate and oth-er clinical results for the two groups were analyzed and compared. Results:The loss of blood was (452.3±137.6) ml in group A and (603.5±99.6) ml in group B,there was significant statistical difference (P<0.05). The time of operation was (193.6±91.2) min in group A and (230.5±56.6) min in group B,there was significant statistical difference (P<0.05). The time of operation and the loss of blood in group A were obviously less than which in group B. In group A 20 cases were cured and 2 cases re-lapsed,19 cases were cured and 1 case relapsed in group B,there was no significant statistical differences between two groups regarding cure rate with chi square test (χ2=0.000,P=1.000). All patients in two groups obtained good clinical curative effect. There were no significant statistical difference between two groups regarding for length of hospital stay with t test (P>0.05). Conclusion:Lumbar spinal tuberculosis with psoas abscess is not absolute indications for anterior open operation. Compared with the combined anterior and posterior surgical procedure ,the percutaneous puncture catheter drainage combined with pos-terior debridement,interbody fusion and internal fixation can achieve the same clinical effect but less trauma for the patients.