Pott's disease surgery: Difference between revisions
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===Surgical Options=== | ===Surgical Options=== | ||
*Surgical therapy for [[Pott's disease|spinal tuberculosis]] is by [[decompression]] of the cord with [[debridement]] of the infected tissue via the anterior or anterolateral approach. | *Surgical therapy for [[Pott's disease|spinal tuberculosis]] is by [[decompression]] of the cord with [[debridement]] of the infected tissue via the anterior or anterolateral approach. | ||
*Anterior transposition of cord with shaving of the internal gibbus can be performed in patients with severe kyphotic deformities with compression of the cord. | *Anterior transposition of cord with shaving of the internal gibbus can be performed in patients with severe kyphotic deformities with compression of the cord.<ref name="pmid28265884">{{cite journal| author=Pan Z, Luo J, Yu L, Chen Y, Zhong J, Li Z et al.| title=Débridement and Reconstruction Improve Postoperative Sagittal Alignment in Kyphotic Cervical Spinal Tuberculosis. | journal=Clin Orthop Relat Res | year= 2017 | volume= | issue= | pages= | pmid=28265884 | doi=10.1007/s11999-017-5306-9 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28265884 }} </ref><ref name="pmid28169940">{{cite journal| author=D'souza AR, Mohapatra B, Bansal ML, Das K| title=Role of Posterior Stabilization and Transpedicular Decompression in the Treatment of Thoracic and Thoracolumbar TB: A Retrospective Evaluation. | journal=Clin Spine Surg | year= 2017 | volume= | issue= | pages= | pmid=28169940 | doi=10.1097/BSD.0000000000000498 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28169940 }} </ref> | ||
*[[Laminectomy]] for decompression is contraindicated in cases with anterior [[Pott's disease|spinal tuberculosis]], as it increases the unstability of the [[spine]]. | *[[Laminectomy]] for decompression is contraindicated in cases with anterior [[Pott's disease|spinal tuberculosis]], as it increases the unstability of the [[spine]].<ref name="pmid28112788">{{cite journal| author=Li J, Huang X, Chen F, Dai F, Zhou Q, Luo F et al.| title=Computed Tomography-Guided Catheterization Drainage to Cure Spinal Tuberculosis With Individualized Chemotherapy. | journal=Orthopedics | year= 2017 | volume= | issue= | pages= 1-7 | pmid=28112788 | doi=10.3928/01477447-20170117-02 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28112788 }} </ref> | ||
==References== | ==References== | ||
Revision as of 18:38, 24 March 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Surgery
Indications for Surgery
Patients with:
- Neurological deficits
- Potential mechanical instability
- Kyphosis leading to sagittal imbalance or severe kyphosis ≥60°
- Large thoracic spine abscess casing esophageal obstruction or cervical abscess causing difficulty in breathing
- Abscess increasing in size even after 3 to 6 months of standard medical therapy
- Worsening neurological function during the period of medical therapy
- Children ≤7 years of age, with three or more affected vertebral bodies
Surgical Options
- Surgical therapy for spinal tuberculosis is by decompression of the cord with debridement of the infected tissue via the anterior or anterolateral approach.
- Anterior transposition of cord with shaving of the internal gibbus can be performed in patients with severe kyphotic deformities with compression of the cord.[1][2]
- Laminectomy for decompression is contraindicated in cases with anterior spinal tuberculosis, as it increases the unstability of the spine.[3]
References
- ↑ Pan Z, Luo J, Yu L, Chen Y, Zhong J, Li Z; et al. (2017). "Débridement and Reconstruction Improve Postoperative Sagittal Alignment in Kyphotic Cervical Spinal Tuberculosis". Clin Orthop Relat Res. doi:10.1007/s11999-017-5306-9. PMID 28265884.
- ↑ D'souza AR, Mohapatra B, Bansal ML, Das K (2017). "Role of Posterior Stabilization and Transpedicular Decompression in the Treatment of Thoracic and Thoracolumbar TB: A Retrospective Evaluation". Clin Spine Surg. doi:10.1097/BSD.0000000000000498. PMID 28169940.
- ↑ Li J, Huang X, Chen F, Dai F, Zhou Q, Luo F; et al. (2017). "Computed Tomography-Guided Catheterization Drainage to Cure Spinal Tuberculosis With Individualized Chemotherapy". Orthopedics: 1–7. doi:10.3928/01477447-20170117-02. PMID 28112788.