Treatment of spinal tuberculosis with CT-guided percutaneous intubation and focal chemotherapy

HOU Xiao-hua; SUN Xiao-wei; YIN Sheng-chun; LIU Guan-hua; ZHANG Xi-feng

doi:10.3969/j.issn.2095-252X.2015.10.011

Abstract：Objective To investigate the therapeutic effects of the treatment of spinal tuberculosis with CT-guided percutaneous intubation and focal chemotherapy.Method From May, 2010 to October, 2013, a total of 27 cases with spinal tuberculosis treated by CT-guided percutaneous intubation and focal chemotherapy were reviewed retrospectively. There were 15 males and 12 females aging from 34 to 88 years old with the average of ( 56±14 ) years old. Nineteen cases received simple persistent focal chemotherapy, while the other 8 cases received persistent irrigation and drainage at the same time. Visual analogue scale ( VAS ) was used to evaluate patients’ complaint of back pain. Erythrocyte sedimentation rate ( ESR ) and C-reactive protein ( CRP ) preoperatively and 1, 2, 3, 4 weeks postoperatively were used to observe infection.Results All surgeries were taken under the guidance of CT scan, and no complications were detected. Persistent irrigation and drainage of tuberculosis abscesses lasted 14 to 52 days ( average: 29±11 days ). Focal chemotherapy lasted 28 to 75 days ( average: 44±12 days ). All patients were followed up for 12 to 30 months ( average: 19±4 months ). No relapse was detected, and abscess disappeared. VAS scale reduced signiifcantly from 6.5±0.9 preoperatively to 2.4±0.7 four weeks postoperatively (P<0.05 ). CRP level before surgery was ( 38.9±11.3 ) mmol / L. In most patients CRP level had a rebound 1 week postoperatively, but was not statistically signiifcant (P>0.05 ). Figures decreased signiifcantly at 2 weeks ( 22.2±7.1 ) (P<0.05 ), and even lower at 3 weeks ( 13.4±3.2 ) and 4 weeks ( 11.1±3.9 ) (P<0.05 ).Conclusions Treatment of spinal tuberculosis with CT-guided percutaneous intubation and focal chemotherapy showed its advantages of good effects and less invasion. And for the aged patients with poor general condition, pain-release and life quality can be improved.