Percutaneous intubation and irrigation under CT guidance for lumbosacral tuberculosis in children

English Keywords:Ｌumbosacral tuberculosis  Percutaneous catheter drainage  Children  Surgical procedures  Minimally invasive

English Abstract:

  【Abstract】 Objectives: To evaluate the clinical efficacy of percutaneous intubation and irrigation under CT guidance for lumbosacral tuberculosis in children. Methods: 9 children suffering from lower lumbar spinal tuberculosis in our institute between January 2006 and February 2011 were reviewed retrospectively. There were 6 males and 3 females with a mean age at surgery of 5.4 years old(range, 2.2 to 7 years). Preoperative ESR and CRP ranged from 25 to 57mm/h(average 39mm/h) and 22.9 to 40mg/L(average 29mg/L) respectively. Preoperative neurological deficits were noted in 4 cases, with 1 Frankel C and 3 Frankel D. All patients underwent routine chemotherapy which consisted of rifampin, isoniazid and ethambutol. 9 children underwent percutaneous intubation, irrigation and continuous focal distillation of isoniazid under CT guidance, after that, all cases had thoracolumbar sacralorthosis(TLSO). Results: All patients received chemotherapy for 9-12 months, PCD for 10-12 weeks and thoracolumbar sacralorthosis(TLSO) for 6-18 months. All cases were followed up for 12-36 months(average, 24 months). 8 children had defect healed completely, tuberculosis recurrence was noted in 1 case due to early cease of chemotherapy, and this case received surgery. No sinus formation was detected, ESR and CRP decreased to normal after an average of 1 and a half months(range, 1 to 3 months). The clinical symptoms completely disappeared and the defect healed. 3 cases with Frankel D recovered to E and 1 from Franke C to D. There was no recurrence after final follow-up． Conclusions： Percutaneous intubation and irrigation under CT guidance is an easy, safe, efficient and less invasive method for lumbosacral vertebral tuberculosis in children on the presence of chemotherapy and thoracolumbar sacralorthosis.