Vaishya Raju, Vijay Vipul, Agarwal Amit K
Department of Orthopaedics, Joint Replacement & Arthroscopy, Indraprastha Apollo Hospital, New Delhi, India.
Arthrosc Tech. 2017 Jul 31;6(4):e1137-e1143. doi: 10.1016/j.eats.2017.03.035. eCollection 2017 Aug.
Tuberculosis of the spine is the second most common extrapulmonary presentation of the disease and is associated with significant morbidity. The drainage of the abscess may be needed in patients who fail to respond to medical treatment and present with a significant or deteriorating neurologic status. The dorsal spine gives a unique opportunity for decompression alone as it is supported by the rib cage, decreasing the chances of collapse. Drainage of the abscess in the dorsal spine usually needs an open thoracotomy. Open thoracotomy is associated with increased blood loss, pain, and increased postoperative rehabilitation period. Video-assisted thoracoscopic surgery (VATS) is an excellent alternative for decompression of dorsal paraspinal abscess with significantly decreased blood loss, soft tissue dissection, scarring, and hospital stay. Overall, this leads to significantly decreased postoperative morbidity and faster recovery. The purpose of this article was to describe the indications and procedure of VATS for drainage of dorsal spine paravertebral abscess.
脊柱结核是该疾病第二常见的肺外表现形式，且与显著的发病率相关。对于药物治疗无反应且出现明显或不断恶化的神经功能状态的患者，可能需要进行脓肿引流。由于胸椎由胸廓支撑，为单纯减压提供了独特的机会，降低了塌陷的几率。胸椎脓肿的引流通常需要开胸手术。开胸手术会导致失血增加、疼痛加剧以及术后康复期延长。电视辅助胸腔镜手术（VATS）是胸椎旁脓肿减压的极佳替代方法，可显著减少失血、软组织分离、瘢痕形成以及住院时间。总体而言，这会显著降低术后发病率并加快康复速度。本文的目的是描述VATS用于胸椎旁脓肿引流的适应症及手术过程。
