BACKGROUND The incidence of lumbar tuberculosis is high worldwide,and effective treatment is a continuing problem.AIM To study the safety and efficacy of the multitrack and multianchor point screw technique combined w...BACKGROUND The incidence of lumbar tuberculosis is high worldwide,and effective treatment is a continuing problem.AIM To study the safety and efficacy of the multitrack and multianchor point screw technique combined with the contralateral Wiltse approach for lesion debridement to treat lumbar tuberculosis.METHODS The C-reactive protein(CRP)level,erythrocyte sedimentation rate(ESR),visual analogue scale(VAS)score,oswestry disability index(ODI)and American Spinal Injury Association(ASIA)grade were recorded and analysed pre-and postoperatively.RESULTS The CRP level and ESR returned to normal,and the VAS score and ODI were decreased at 3 mo postoperatively,with significant differences compared with the preoperative values(P<0.01).Neurological dysfunction was relieved,and the ASIA grade increased,with no adverse events.CONCLUSION The multitrack,multianchor point screw fixation technique combined with the contralateral Wiltse approach for debridement is an effective and safe method for the treatment of lumbar tuberculosis.展开更多
Objective: To explore the clinicpathologic features and MRI manifestations of the thoracic lumbar tuberculosis by underwenting MRI and pathological examinations. Methods: 34 cases of Thoracic lumbar tuberculosis were ...Objective: To explore the clinicpathologic features and MRI manifestations of the thoracic lumbar tuberculosis by underwenting MRI and pathological examinations. Methods: 34 cases of Thoracic lumbar tuberculosis were collected which underwent MRI examination and confirmed by pathology or treatment of anti-TB drugs, the clinical cure from June 2008 to June 2012 in our hospital. The first MRI was performed on all patients, to determine the MRI findings, and surgical treatment for pathological examination in order to determine the pathological features. Results: 34 patients with 81 vertebral involvement, in which two adjacent vertebral involvement is the common, accounting for 72.25%, vertebral showed uneven long T1, long T2 signal. Intervertebral disc abnormalities accounted for 90.17%, the performance showed long T1, long T2 signal changes in the intervertebral disc damage, often accompanied by disc space narrowing or disappear. Paraspinal abscess accounted for 90.67%, often more than vertebra, up and down across one or more vertebral bodies showed long T1, long T2 signal. The vertebrae were damaged kyphosis or (and) the posterior longitudinal ligament abscess caused by the dural sac and spinal column with pressure accounted for 74.72%. In enhanced scan, vertebrae, intervertebral discs showed heterogeneous enhancement, paraspinal abscess was curved or ring enhancement. The pathological diagnosis may be obvious to confirm the degree of swelling and lesions. Conclusion: By doing the MRI and pathologic examinations, it can determine the clinical and pathological features and MRI findings of spinal tuberculosis patients with Thoracic lumbar spinal tuberculosis, and lay a reliable foundation for the treatment of the subsequent treatment.展开更多
Mycobacterium paragordonae(M.paragordonae),a slow-growing,acid-resistant mycobacterial species,was first isolated from the sputum of a lung infection patient in South Korea in 2014.Infections caused by M.paragordonae ...Mycobacterium paragordonae(M.paragordonae),a slow-growing,acid-resistant mycobacterial species,was first isolated from the sputum of a lung infection patient in South Korea in 2014.Infections caused by M.paragordonae are rare.CASE SUMMARY Herein,we report the case of a 53-year-old patient who presented with fever and low back pain.Lumbar nuclear magnetic resonance imaging revealed the destruction of the lumbar vertebra with peripheral abscess formation.After antiinfective and diagnostic anti-tuberculosis treatment,the patient had no further fever,but the back pain was not relieved.Postoperatively,the necrotic material was sent for pathological examination,and all tests related to tuberculosis were negative,but pus culture suggested nontuberculous mycobacteria.The necrotic tissue specimens were subjected to metagenomic next-generation sequencing,which indicated the presence of M.paragordonae.Finally,the infecting pathogen was identified,and the treatment plan was adjusted.The patient was in good condition during the follow-up period.CONCLUSION M.paragordonae,a rare nontuberculous mycobacterium,can also cause spinal infections.In the clinic,it is necessary to identify nontuberculous mycobacteria for spinal infections similar to Mycobacterium tuberculosis.展开更多
To review the clinical efficacy of minimally invasive pedicle fixation combined with anterior small incision focus debridement for single-segment lumbar spine tuberculosis,a total of 31 patients with single-segment ma...To review the clinical efficacy of minimally invasive pedicle fixation combined with anterior small incision focus debridement for single-segment lumbar spine tuberculosis,a total of 31 patients with single-segment marginal lumbar tuberculosis were enrolled in the study.All the patients received quadruple anti-tuberculosis chemotherapy for 2 weeks before surgery and treatment with minimally invasive posterior internal fixation,anterior small incision focus debridement,and bone graft fusion.Those patients with preoperative kyphosis deformity were initially treated with appropriate posterior distraction correction.Except for 1 patient who healed 2 weeks after medical dressing change,the remaining30 patients healed as expected.All the patients had no screwrelated surgical complications,neurological dysfunction,vascular injury,and other complications.The average visual analog scale scores at 3 months postoperatively were significantly decreased to1.4±1.5(P<0.05).In conclusion,under the premise of treatment using appropriate,effective anti-tuberculosis agents,this surgical procedure for managing patients with lumbar vertebral tuberculosis achieved satisfactory results,effectively reducing the exposure range and fusion segments in simple anterior focus debridement and internal fixation.Using minimally invasive posterior pedicle screw fixation can effectively increase spine stability,reduce fusion segment,and decrease anterior surgical trauma and complications.展开更多
基金Supported by 2023 Hebei Province Medical Science Research Project Plan,No.20231958。
文摘BACKGROUND The incidence of lumbar tuberculosis is high worldwide,and effective treatment is a continuing problem.AIM To study the safety and efficacy of the multitrack and multianchor point screw technique combined with the contralateral Wiltse approach for lesion debridement to treat lumbar tuberculosis.METHODS The C-reactive protein(CRP)level,erythrocyte sedimentation rate(ESR),visual analogue scale(VAS)score,oswestry disability index(ODI)and American Spinal Injury Association(ASIA)grade were recorded and analysed pre-and postoperatively.RESULTS The CRP level and ESR returned to normal,and the VAS score and ODI were decreased at 3 mo postoperatively,with significant differences compared with the preoperative values(P<0.01).Neurological dysfunction was relieved,and the ASIA grade increased,with no adverse events.CONCLUSION The multitrack,multianchor point screw fixation technique combined with the contralateral Wiltse approach for debridement is an effective and safe method for the treatment of lumbar tuberculosis.
文摘Objective: To explore the clinicpathologic features and MRI manifestations of the thoracic lumbar tuberculosis by underwenting MRI and pathological examinations. Methods: 34 cases of Thoracic lumbar tuberculosis were collected which underwent MRI examination and confirmed by pathology or treatment of anti-TB drugs, the clinical cure from June 2008 to June 2012 in our hospital. The first MRI was performed on all patients, to determine the MRI findings, and surgical treatment for pathological examination in order to determine the pathological features. Results: 34 patients with 81 vertebral involvement, in which two adjacent vertebral involvement is the common, accounting for 72.25%, vertebral showed uneven long T1, long T2 signal. Intervertebral disc abnormalities accounted for 90.17%, the performance showed long T1, long T2 signal changes in the intervertebral disc damage, often accompanied by disc space narrowing or disappear. Paraspinal abscess accounted for 90.67%, often more than vertebra, up and down across one or more vertebral bodies showed long T1, long T2 signal. The vertebrae were damaged kyphosis or (and) the posterior longitudinal ligament abscess caused by the dural sac and spinal column with pressure accounted for 74.72%. In enhanced scan, vertebrae, intervertebral discs showed heterogeneous enhancement, paraspinal abscess was curved or ring enhancement. The pathological diagnosis may be obvious to confirm the degree of swelling and lesions. Conclusion: By doing the MRI and pathologic examinations, it can determine the clinical and pathological features and MRI findings of spinal tuberculosis patients with Thoracic lumbar spinal tuberculosis, and lay a reliable foundation for the treatment of the subsequent treatment.
文摘Mycobacterium paragordonae(M.paragordonae),a slow-growing,acid-resistant mycobacterial species,was first isolated from the sputum of a lung infection patient in South Korea in 2014.Infections caused by M.paragordonae are rare.CASE SUMMARY Herein,we report the case of a 53-year-old patient who presented with fever and low back pain.Lumbar nuclear magnetic resonance imaging revealed the destruction of the lumbar vertebra with peripheral abscess formation.After antiinfective and diagnostic anti-tuberculosis treatment,the patient had no further fever,but the back pain was not relieved.Postoperatively,the necrotic material was sent for pathological examination,and all tests related to tuberculosis were negative,but pus culture suggested nontuberculous mycobacteria.The necrotic tissue specimens were subjected to metagenomic next-generation sequencing,which indicated the presence of M.paragordonae.Finally,the infecting pathogen was identified,and the treatment plan was adjusted.The patient was in good condition during the follow-up period.CONCLUSION M.paragordonae,a rare nontuberculous mycobacterium,can also cause spinal infections.In the clinic,it is necessary to identify nontuberculous mycobacteria for spinal infections similar to Mycobacterium tuberculosis.
基金supported by the National Natural Science Foundation of China(No.81272024).
文摘To review the clinical efficacy of minimally invasive pedicle fixation combined with anterior small incision focus debridement for single-segment lumbar spine tuberculosis,a total of 31 patients with single-segment marginal lumbar tuberculosis were enrolled in the study.All the patients received quadruple anti-tuberculosis chemotherapy for 2 weeks before surgery and treatment with minimally invasive posterior internal fixation,anterior small incision focus debridement,and bone graft fusion.Those patients with preoperative kyphosis deformity were initially treated with appropriate posterior distraction correction.Except for 1 patient who healed 2 weeks after medical dressing change,the remaining30 patients healed as expected.All the patients had no screwrelated surgical complications,neurological dysfunction,vascular injury,and other complications.The average visual analog scale scores at 3 months postoperatively were significantly decreased to1.4±1.5(P<0.05).In conclusion,under the premise of treatment using appropriate,effective anti-tuberculosis agents,this surgical procedure for managing patients with lumbar vertebral tuberculosis achieved satisfactory results,effectively reducing the exposure range and fusion segments in simple anterior focus debridement and internal fixation.Using minimally invasive posterior pedicle screw fixation can effectively increase spine stability,reduce fusion segment,and decrease anterior surgical trauma and complications.
