Arora Sumit, Kumar Ramesh, Batra Sumit, Nath Rohit
Department of Orthopaedic Surgery, Maulana Azad Medical College and Associated Lok Nayak Hospital, G.B. Pant Hospital, New Delhi, India.
J Spinal Disord Tech. 2011 May;24(3):E26-30. doi: 10.1097/BSD.0b013e3181ecf873.
We describe 3 patients with lumbosacral tuberculosis with epidural and presacral abscess who presented to us with acute cauda equina syndrome. A novel technique of draining the abscess and its results are described.
To describe a novel technique of draining the presacral abscess and to evaluate the results in the patients treated with this technique.
Osteoarticular tuberculosis, especially spinal tuberculosis, is a major health problem in developing regions of world. The presacral region is one of the uncommon yet difficult regions for the drainage of abscess. Acute cauda equina syndrome because of lumbosacral tuberculosis is a rare entity. We describe a series of 3 such cases of tubercular etiology who presented to us with cauda equina syndrome.
All of them had complete neurologic recovery within 3 weeks of performing transpedicular drainage of presacral abscess and cauda equina nerve root decompression by laminotomy. All the patients were asymptomatic with normal blood parameters and healed radiologic status at 2 years follow-up.
The transpedicular approach to the presacral region is a safer option compared with other approaches to reach this region. It simultaneously allows decompression of cauda equina nerve roots by laminotomy without changing the position of the patient in the theater. The key to success with this approach is early diagnosis and early treatment.
我们描述了3例腰骶部结核合并硬膜外及骶前脓肿并以急性马尾综合征就诊的患者。描述了一种引流脓肿的新技术及其结果。
描述一种引流骶前脓肿的新技术，并评估采用该技术治疗的患者的结果。
骨关节结核，尤其是脊柱结核，是世界上发展中地区的一个主要健康问题。骶前区域是脓肿引流少见但困难的区域之一。腰骶部结核导致的急性马尾综合征是一种罕见情况。我们描述了3例因结核病因以马尾综合征就诊的病例。
通过经椎弓根引流骶前脓肿及椎板切开减压马尾神经根，所有患者在3周内均实现了完全神经功能恢复。在2年随访时，所有患者均无症状，血液参数正常，影像学检查结果愈合。
与到达该区域的其他方法相比，经椎弓根入路至骶前区域是一种更安全的选择。它同时允许通过椎板切开术对马尾神经根进行减压，而无需在手术台上改变患者体位。该方法成功的关键是早期诊断和早期治疗。
