Treatment of pediatric spinal tuberculosis abscess with percutaneous drainage and low-dose local antituberculous therapy: a preliminary report

Childs Nerv Syst. 2015 Jul;31(7):1149-55. doi: 10.1007/s00381-015-2694-6. Epub 2015 Apr 12.

Abstract

Objective: The purpose of this study was to evaluate the outcomes of computed tomography (CT) guidance using percutaneous catheter with low-dose drainage local chemotherapy (modified PCD) and antituberculous therapy (ATT) for the treatment of spinal tuberculosis in children.

Methods: Twenty-seven children suffering from spinal tuberculosis were treated with modified PCD and ATT in our institute from 2002 to 2012. We describe our treatment, which involves CT-guided percutaneous puncture and local chemotherapy (continuous low-dose (20 mL) irrigation). The patients were evaluated based on the Frankel scoring system, the kyphotic Cobb angle, and the erythrocyte sedimentation rate (ESR).

Results: All patients were followed up for an average of 31.00 ± 13.94 months. No sinus formation was detected. All patients responded well to this treatment. The ESR values were decreased to normal at last follow-up. The neurological functions show significant improvement after operation. Preoperatively, the kyphotic angle was 22.89 ± 7.06°, and it was measured as 21.19 ± 8.73° at the last visit.

Conclusions: Our results showed that percutaneous intubation and low-dose irrigation under CT guidance (modified percutaneous catheter drainage (MPCD)) and ATT are easy, safe, efficient, and less invasive methods for the treatment of spinal tuberculosis in children.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abscess* / drug therapy
  • Abscess* / etiology
  • Abscess* / surgery
  • Antitubercular Agents / therapeutic use*
  • Catheterization / methods*
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Retrospective Studies
  • Tomography Scanners, X-Ray Computed
  • Tuberculosis, Spinal* / complications
  • Tuberculosis, Spinal* / drug therapy
  • Tuberculosis, Spinal* / surgery

Substances

  • Antitubercular Agents