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題名 | Tuberculous Spondylitis Presenting with Psoas Abscess=結核性脊椎炎以腰大肌膿瘍呈現 |
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作者 | 羅永智; 李協興; 吳興盛; Lo, Yung-chih; Lee, Hsieh-hsing; Wu, Shing-sheng; |
期刊 | 臺灣外科醫學會雜誌 |
出版日期 | 20090300、20090400 |
卷期 | 42:2 2009.03-04[民98.03-04] |
頁次 | 頁100-105 |
分類號 | 416.61 |
語文 | eng |
關鍵詞 | 結核性脊椎炎; 腰大肌膿瘍; Psoas abscess; Tuberculous spondylitis; |
中文摘要 | 四病例源自結核性脊椎炎的腰大肌膿瘍,藉由CT、MRI診斷且有術中組織培養證實。侵犯的範圍有L4/5、L2/3、L2、T12,治療的方式爲一例CT導引引流,二例後位清創術,一例前位清創術並後位融合術:使用抗結核藥物治療爲期5至9個月。無手術的併發症,術後追蹤二年並無復發。在早期診斷、抗結核藥物治療、適當的手術引流,對於結核性脊椎炎起源的腰大肌膿瘍,會有較好的預後。 |
英文摘要 | We report four cases of tuberculous spondylitis presenting with psoas abscess treated at our hospital from January 2001 to December 2002. One patient was male and three were female. The diagnosis in each case was made by computerized tomography and magnetic resonance imaging, thereafter confirmed by intra-operative cultures. The levels involved were: L4/5 (1 case), L2/3 (1 case), L2 (1 case), and T12 (1 case). The ways of intervention were CT-guided drainage only in one patient, posterior debridement with drainage in two, and anterior debridement combined with posterior instrumented posterolateral fusion in the remaing one. Anti-tuberculous medications were administered to all the four patients for 5-9 months postoperatively. No surgical complication was noted. Nor did recurrence of tuberculosis develop by the end of the follow-up period at least two years postoperatively. Management of psoas abscess associated with tuberculous spondylitis may achieve a good outcome if diagnosed early and treated with adequate surgical drainage and anti-tuberculous medications. |
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