Application of intervertebral foramen mirror technology in the diagnosis and treatment of spinal tuberculous abscess

Jiang Xiaohang; Lu feng

doi:10.11850/j.issn.1009-122X.2017.01.004

Abstract：Objective To evaluate the application value of intervertebral foramen mirror (IFM) technology in the diagnosis and treatment of spinal tuberculous abscess.Methods Clinical data of 36 spinal tuberculous patients with paravertebral abscess were analyzed retrospectively,including 12 patients who underwent debridement and drainage of spinal tuberculous abscess by IFM technology as IFM group and 24 who received CT-guided percutaneous drainage as CT group.The positivity rates of smear for tuberculosis bacili,Mycobacterium tuberculosis culture and pathological examination of spinal tuberculous abscess,and cure rate of abscess,extubation time,hospital stay and cure time were compared between the two groups.Results All the patients were cured and the cure rate was 100％ after the follow-up period of 12 to 18 months.The positivity rates of pathological examination in IFM group and CT group were 83.3％ and 37.5％ and positivity rates of Mycobacterium tuberculosis culture were 83.3％ and 45.8％,respectively.And the positivity rate of pathological examination and Myeobaeterium tuberculosis culture were increased significantly in IFM group (P ＜ 0.05).The extubation time in IFM group and CT group was (22.0±3.6) d and (27.0±4.5) d,hospital stay (25.0±2.7) d and (29.0±5.1) d,cure time (165.0±29.8) d and (189.0±23.7) d,respectively.The extubation time,hospital stay and cure time were shorter significantly in IFM group (P ＜ 0.05).Multivariate analysis by Cox regression model showed that the IFM technology was an independent protection factor for the cure time,hospital stay and extubation time (P =0.017,0.011,0.009).Conclusions On the basis of the systemic therapy with anti-tubercular drugs,debridement and drainage by IFM technology can obtain etiological evidence in order to make a definite diagnosis and improve the outcome of the patients,especially for the spinal tuberculous abscess patients without nerve dysfunction and paralysis,is better than CT-guided percutaneous drainage.