Cargando…

Minimally invasive technique for the abscess drainage in lumbosacral tuberculosis using arthroscopy sheath: A case report

INTRODUCTION: Spinal tuberculosis usually affects the thoracolumbar spine, with only 2–3% involving the lumbosacral region. Lumbosacral tuberculosis can lead to the formation of a presacral abscess. For drainage of the spinal abscess, the presacral region is one of the problematic regions to perform...

Descripción completa

Detalles Bibliográficos
Autores principales: Tobing, Singkat Dohar Apul Lumban, Kurniawan, Dody
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7305372/
https://www.ncbi.nlm.nih.gov/pubmed/32563084
http://dx.doi.org/10.1016/j.ijscr.2020.04.007
_version_ 1783548446136860672
author Tobing, Singkat Dohar Apul Lumban
Kurniawan, Dody
author_facet Tobing, Singkat Dohar Apul Lumban
Kurniawan, Dody
author_sort Tobing, Singkat Dohar Apul Lumban
collection PubMed
description INTRODUCTION: Spinal tuberculosis usually affects the thoracolumbar spine, with only 2–3% involving the lumbosacral region. Lumbosacral tuberculosis can lead to the formation of a presacral abscess. For drainage of the spinal abscess, the presacral region is one of the problematic regions to perform. Minimally invasive surgery (MIS) is an essential clinical technique for the debridement of the spinal abscess in order to decrease the morbidity acquired by the patient. We presented a case of lumbosacral tuberculosis treated with abscess evacuation using the MIS technique. PRESENTATION OF CASE: A 28-year-old male came with the chief complaint of back pain and a lump in the right groin area for four months before admission. Physical examination showed a lump and bilateral positive straight leg raising. Preoperative Oswestry Disability Index (ODI) and the Japanese Orthopaedic Association (JOA) scores showed moderate disability and normal function, respectively. Radiologic examinations showed signs of lumbosacral tuberculosis. The patient underwent abscess evacuation using MIS of presacral approach as described for axial lumbar interbody fusion (AxiaLIF), and improvement in ODI score was noted. DISCUSSION: A presacral approach, as what we performed, is a simple approach that can reach the location of the abscess by using fluoroscopic guidance. Abscess evacuation was confirmed by the presence of clear fluid, which indicated that the caseous material had been removed thoroughly, and also, as the clear fluid was no longer noticed. CONCLUSION: The success of this approach depends on the time of surgery. When surgery is delayed, the granulation tissue has been formed, making minimally invasive techniques for surgical evacuation much more difficult.
format Online
Article
Text
id pubmed-7305372
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-73053722020-06-22 Minimally invasive technique for the abscess drainage in lumbosacral tuberculosis using arthroscopy sheath: A case report Tobing, Singkat Dohar Apul Lumban Kurniawan, Dody Int J Surg Case Rep Article INTRODUCTION: Spinal tuberculosis usually affects the thoracolumbar spine, with only 2–3% involving the lumbosacral region. Lumbosacral tuberculosis can lead to the formation of a presacral abscess. For drainage of the spinal abscess, the presacral region is one of the problematic regions to perform. Minimally invasive surgery (MIS) is an essential clinical technique for the debridement of the spinal abscess in order to decrease the morbidity acquired by the patient. We presented a case of lumbosacral tuberculosis treated with abscess evacuation using the MIS technique. PRESENTATION OF CASE: A 28-year-old male came with the chief complaint of back pain and a lump in the right groin area for four months before admission. Physical examination showed a lump and bilateral positive straight leg raising. Preoperative Oswestry Disability Index (ODI) and the Japanese Orthopaedic Association (JOA) scores showed moderate disability and normal function, respectively. Radiologic examinations showed signs of lumbosacral tuberculosis. The patient underwent abscess evacuation using MIS of presacral approach as described for axial lumbar interbody fusion (AxiaLIF), and improvement in ODI score was noted. DISCUSSION: A presacral approach, as what we performed, is a simple approach that can reach the location of the abscess by using fluoroscopic guidance. Abscess evacuation was confirmed by the presence of clear fluid, which indicated that the caseous material had been removed thoroughly, and also, as the clear fluid was no longer noticed. CONCLUSION: The success of this approach depends on the time of surgery. When surgery is delayed, the granulation tissue has been formed, making minimally invasive techniques for surgical evacuation much more difficult. Elsevier 2020-05-19 /pmc/articles/PMC7305372/ /pubmed/32563084 http://dx.doi.org/10.1016/j.ijscr.2020.04.007 Text en © 2020 Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Tobing, Singkat Dohar Apul Lumban
Kurniawan, Dody
Minimally invasive technique for the abscess drainage in lumbosacral tuberculosis using arthroscopy sheath: A case report
title Minimally invasive technique for the abscess drainage in lumbosacral tuberculosis using arthroscopy sheath: A case report
title_full Minimally invasive technique for the abscess drainage in lumbosacral tuberculosis using arthroscopy sheath: A case report
title_fullStr Minimally invasive technique for the abscess drainage in lumbosacral tuberculosis using arthroscopy sheath: A case report
title_full_unstemmed Minimally invasive technique for the abscess drainage in lumbosacral tuberculosis using arthroscopy sheath: A case report
title_short Minimally invasive technique for the abscess drainage in lumbosacral tuberculosis using arthroscopy sheath: A case report
title_sort minimally invasive technique for the abscess drainage in lumbosacral tuberculosis using arthroscopy sheath: a case report
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7305372/
https://www.ncbi.nlm.nih.gov/pubmed/32563084
http://dx.doi.org/10.1016/j.ijscr.2020.04.007
work_keys_str_mv AT tobingsingkatdoharapullumban minimallyinvasivetechniquefortheabscessdrainageinlumbosacraltuberculosisusingarthroscopysheathacasereport
AT kurniawandody minimallyinvasivetechniquefortheabscessdrainageinlumbosacraltuberculosisusingarthroscopysheathacasereport