Pott's disease surgery: Difference between revisions
Jump to navigation
Jump to search
| Line 6: | Line 6: | ||
==Surgery== | ==Surgery== | ||
===Indications for Surgery=== | ===Indications for Surgery=== | ||
The following are the indications for surgery in patients with [[Pott's disease]]:<ref name="pmid28063678">{{cite journal| author=Wang YX, Zhang HQ, Li M, Tang MX, Guo CF, Deng A et al.| title=Debridement, interbody graft using titanium mesh cages, posterior instrumentation and fusion in the surgical treatment of multilevel noncontiguous spinal tuberculosis in elderly patients via a posterior-only. | journal=Injury | year= 2017 | volume= 48 | issue= 2 | pages= 378-383 | pmid=28063678 | doi=10.1016/j.injury.2016.12.025 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28063678 }} </ref><ref name="pmid28056436">{{cite journal| author=Liu JM, Zhou Y, Peng AF, Chen XY, Chen WZ, Long XH et al.| title=One-stage posterior surgical management of lumbosacral spinal tuberculosis with nonstructural autograft. | journal=Clin Neurol Neurosurg | year= 2017 | volume= 153 | issue= | pages= 67-72 | pmid=28056436 | doi=10.1016/j.clineuro.2016.12.013 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28056436 }} </ref> | The following are the indications for surgery in patients with [[Pott's disease]]:<ref name="pmid28063678">{{cite journal| author=Wang YX, Zhang HQ, Li M, Tang MX, Guo CF, Deng A et al.| title=Debridement, interbody graft using titanium mesh cages, posterior instrumentation and fusion in the surgical treatment of multilevel noncontiguous spinal tuberculosis in elderly patients via a posterior-only. | journal=Injury | year= 2017 | volume= 48 | issue= 2 | pages= 378-383 | pmid=28063678 | doi=10.1016/j.injury.2016.12.025 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28063678 }} </ref><ref name="pmid28056436">{{cite journal| author=Liu JM, Zhou Y, Peng AF, Chen XY, Chen WZ, Long XH et al.| title=One-stage posterior surgical management of lumbosacral spinal tuberculosis with nonstructural autograft. | journal=Clin Neurol Neurosurg | year= 2017 | volume= 153 | issue= | pages= 67-72 | pmid=28056436 | doi=10.1016/j.clineuro.2016.12.013 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28056436 }} </ref><ref name="pmid27990623">{{cite journal| author=Peng L, Hai N| title=The effect of time-to-surgery on outcome in patients with neurological deficits caused by spinal tuberculosis. | journal=Turk Neurosurg | year= 2016 | volume= | issue= | pages= | pmid=27990623 | doi=10.5137/1019-5149.JTN.18736-16.1 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27990623 }} </ref> | ||
*Neurological deficits | *Neurological deficits | ||
*Potential [[mechanical instability]] | *Potential [[mechanical instability]] | ||
Revision as of 14:31, 27 March 2017
|
Pott's disease Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Pott's disease surgery On the Web |
|
American Roentgen Ray Society Images of Pott's disease surgery |
|
Risk calculators and risk factors for Pott's disease surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Surgery
Indications for Surgery
The following are the indications for surgery in patients with Pott's disease:[1][2][3]
- 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.[4]
- Anterior transposition of cord with shaving of the internal gibbus can be performed in patients with severe kyphotic deformities with compression of the cord.[5][6]
- Laminectomy for decompression is contraindicated in cases with anterior spinal tuberculosis, as it increases the unstability of the spine.[7]
References
- ↑ Wang YX, Zhang HQ, Li M, Tang MX, Guo CF, Deng A; et al. (2017). "Debridement, interbody graft using titanium mesh cages, posterior instrumentation and fusion in the surgical treatment of multilevel noncontiguous spinal tuberculosis in elderly patients via a posterior-only". Injury. 48 (2): 378–383. doi:10.1016/j.injury.2016.12.025. PMID 28063678.
- ↑ Liu JM, Zhou Y, Peng AF, Chen XY, Chen WZ, Long XH; et al. (2017). "One-stage posterior surgical management of lumbosacral spinal tuberculosis with nonstructural autograft". Clin Neurol Neurosurg. 153: 67–72. doi:10.1016/j.clineuro.2016.12.013. PMID 28056436.
- ↑ Peng L, Hai N (2016). "The effect of time-to-surgery on outcome in patients with neurological deficits caused by spinal tuberculosis". Turk Neurosurg. doi:10.5137/1019-5149.JTN.18736-16.1. PMID 27990623.
- ↑ Golwala P, Kapoor C, Shah M, Merh A, Kansagra A (2016). "A Case of Koch's Spine Treated with Modified Transpedicular Vertebral Curettage and Posterior Fixation: A Novel Technique". Cureus. 8 (12): e915. doi:10.7759/cureus.915. PMC 5218885. PMID 28083459.
- ↑ 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.