scholarly journals Pott’s Disease in a 2-Year-Old Child Treated by Decompression and Anterior-Posterior Instrumented Fusion

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Mehmet Nuri Erdem ◽  
Cem Sever ◽  
Mehmet Fatih Korkmaz ◽  
Sinan Karaca ◽  
Ferit Kirac ◽  
...  
Keyword(s):  
Posterior Instrumentation ◽  
Spinal Tuberculosis ◽  
Vertebral Osteomyelitis ◽  
Pedicle Screws ◽  
Early Mobilization ◽  
Instrumented Fusion ◽  
Pott’S Disease ◽  
Rod System ◽  
Paraspinal Abscess ◽  
Anterior Posterior

Introduction. Paraplegia and kyphotic deformity are two major disease-related problems of spinal tuberculosis, especially in the early age disease. In this study a 2-year-old boy who underwent surgical decompression, correction, and 360° instrumented fusion via simultaneous anterior-posterior technique for Pott’s disease was reported.Case Report. A 2-year-and-9-month-old boy presented with severe back pain and paraparesis of one-month duration. Thoracic magnetic resonance imaging demonstrated destruction with a large paraspinal abscess involving T5-T6-T7 levels, compressing the spinal cord. The paraspinal abscess drained and three-level corpectomy was performed at T5-6-7 with transthoracic approach. Anterior instrumentation and fusion was performed with structural 1 autogenous fibula and rib graft using screw-rod system. In prone position pedicle screws were inserted at T4 and T8 levels and rods were placed. Six months after surgery, there was no weakness or paraparesis and no correction loss at the end of follow-up period.Discussion. In cases of vertebral osteomyelitis with severe anterior column destruction in the very early child ages the use of anterior structural grafts and instrumentation in combination with posterior instrumentation is safe and effective in maintenance of the correction achieved and allows efficient stabilization and early mobilization.

scholarly journals A case of not just Pott’s disease

2021 ◽  
Vol 8 ◽  
pp. 204993612110414
Author(s):  
William Greene ◽  
Martin Prager ◽  
Marlin Richardson
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Epidural Abscess ◽  
Spinal Tuberculosis ◽  
Vertebral Osteomyelitis ◽  
Streptococcus Anginosus ◽  
Pott’S Disease ◽  
Developed World

Spinal tuberculosis (TB) is a rare cause of vertebral osteomyelitis in the developed world. Co-infections with other microorganisms are seldom reported in the literature. Here we report a case of Mycobacterium tuberculosis and Streptococcus anginosus causing acute on chronic vertebral osteomyelitis with an epidural abscess.

scholarly journals Surgical treatment of preschool childhood spinal thoracic tuberculosis: two case reports and technical note

2018 ◽  
Vol 32 (1) ◽  
pp. 85-93
Author(s):  
Mehmet Nuri Erdem ◽  
Anas Abdallah ◽  
Sinan Karaca ◽  
Mehmet Aydoğan
Keyword(s):  
Surgical Treatment ◽  
Case Reports ◽  
Pediatric Population ◽  
Posterior Instrumentation ◽  
Spinal Tuberculosis ◽  
Technical Note ◽  
Neurological Deficits ◽  
Pott’S Disease ◽  
Surgical Options

AbstractBackground: The development of paraplegia and kyphosis are two important problems related to spinal tuberculosis (Pott’s disease) in children. The current study aims to present two pediatric Pott’s disease, point out the progression of this disease in children, surgical options and surgical outcomes.Materials and methods: Two cases of childhood Pott’s disease were referred to our department with progressive neurological deficits (both of children were experienced bilateral weakness in lower extremities; grade C according to Frankel scale) during short periods (less than one month per each). Both cases’ MRIs are demonstrated abscesses in thoracic spine. Both patients are treated surgically. We discussed in this study the technical notes in both cases, especially in 2- year-old child.Results: Both cases were treated surgically after decompressing nerve roots and thecal sac posterior instrumentation was applied. Microbiological examination of both samples revealed on M.Tuberculosis. Orthoses are applied three months after operations. Antituberculosis medication protocol was applied. Preoperative paraparesis had recovered completely and muscle strengths all returned to normal in both children. There is no loss of correction during the follow-up periods.Conclusion: Spinal tuberculosis is a dynamic disease that may lead to severe deformities in childhood. Especially in cases where two or more vertebrae are affected, early surgical treatment is essential to prevent severe kyphosis. Surgical intervention accompanied with antituberculosis medications protocol is essential to cure treatment in pediatric population. In children aged ≤6 years and more than one vertebrae were affected, fıbula can be used to allow growth of the child vertebral column.

Transpedicular screw-rod fixation of the lumbar spine: operative technique and outcome in 104 cases

1992 ◽  
Vol 77 (6) ◽  
pp. 860-870 ◽  
Author(s):  
Curtis A. Dickman ◽  
Richard G. Fessler ◽  
Michael MacMillan ◽  
Regis W. Haid
Keyword(s):  
Lumbar Spine ◽  
Internal Fixation ◽  
Vertebral Osteomyelitis ◽  
Spinal Instrumentation ◽  
Pedicle Screws ◽  
Spinal Epidural Hematoma ◽  
Content Type ◽  
Operative Revision ◽  
Rod System ◽  
Fine Print

✓ A total of 104 patients underwent transpedicular spinal instrumentation using the Cotrel-Dubousset (71 cases) or the Texas Scottish Rite Hospital (33) screw-rod system. Surgery was performed for lumbar vertebral column instability secondary to fractures (28 cases), spondylolisthesis (29), tumors (four), vertebral osteomyelitis (two), or postoperative causes (41). Pseudoarthrodesis due to failure of a prior fusion was present in 37 cases. The 55 men and 49 women (mean age 47 years, range 18 to 87 years) all presented with severe back pain. Signs or symptoms of neural compression were noted in 96 patients. Surgery consisted of neural decompression, internal fixation, and autogenous iliac bone grafting. Spondylolistheses were fused in situ, without reduction; otherwise, major spinal deformities were corrected. A total of 516 pedicle screws were placed. The mean extent of fusion was 2.7 motion segments (range one to six motion segments). A 96% fusion rate was obtained with a mean follow-up period of 20 months. There were no operative deaths. Major complications included one spinal epidural hematoma, three isolated nerve root deficits (two transient, one permanent), and three wound infections (two deep, one superficial). Instrument failure eventually developed in 18 patients; nine were asymptomatic with a solid fusion and did not require further treatment and the other nine were symptomatic or had a pseudoarthrosis and required operative revision. Pedicle screw-rod fixation offers biomechanical advantages compared to other forms of internal fixation for the lumbar spine. It enables short-segment fixation with preservation of lumbar lordosis and adjacent normal motion segments. This technique provides a highly successful method to obtain arthrodesis, even with prior pseudoarthrosis.

A Rare Case of Spinal Leprosy Mimicking Spinal Tuberculosis

2019 ◽  
pp. 33
Author(s):  
K Thuraikumar ◽  
V Naveen ◽  
Mustaqim A ◽  
Arieff AA ◽  
K Shri ◽  
...  
Keyword(s):  
Back Pain ◽  
Soft Tissue ◽  
Histopathological Examination ◽  
Posterior Instrumentation ◽  
Spinal Tuberculosis ◽  
Previous History ◽  
Skin Lesions ◽  
Titanium Implants ◽  
Paravertebral Abscess ◽  
History Of

Introduction: Spinal tuberculosis is the most common manifestation of extrapulmonar y tuberculosis. A combination of leprosy and tuberculosis is a rare entity.Case report: A 44-year-old male patient working as a laborer presented to our hospital with complaints of severe back pain and swelling over the back, difficulty in walking, associated with constitutional symptoms. On admission, he was febrile and had leukocytosis. Initial spine X-ray showed end plate destruction and increase in soft tissue shadow at the level of T8-T9. CT spine revealed thoracic paravertebral collection extending from T7 to T9 levels, suggest ive of tuberculous spondylitis with cold abscess. Patient refused a transpedicular biopsy and was started on anti-tubercular therapy. Two weeks after commencement of treatment, he developed worsening back pain and weakness of the lower extremities. MRI spine showed a paravertebral abscess and posterior soft tissue edema involving level of T7 to T11. Patient underwent a posterior decompression, debridement and posterior instrumentation. He was discharged well, there was improvement of his lower limb power. Upon clinic review, he complained of multiple hyperpigmented, painless, nonpruritic skin lesions over the trunk and back. No previous history of eczema, psoriasis and Tinea corporis. Given the history of allergy, initial impression was hypersensitivity reaction towards the titanium implants, and he was started on anti-histamines. However, there was no improvements seen. Histopathological examination of skin lesions revealed presence of granuloma within the dermis layer, composed of epitheloid, histiocytes, lymphocytes and plasma cells. Wade-Fite stain for Mycobacterium leprae is positive. Slit skin smear shows multibacillary leprosy. Patient was started on multidrug therapy (rifampicin, clofazimine and dapsone) for 1 year. He has recovered well.International Journal of Human and Health Sciences Supplementary Issue: 2019 Page: 33

Transpedicular Surgical Decompression of Dorsal Spinal Tuberculosis (Pott’s Disease) with Vertebral Collapse without Fixation

2016 ◽  
Vol 01 (02) ◽  
Author(s):  
Deepak K Jha ◽  
Rahul Singh ◽  
Ishita Pant ◽  
Mukul Jain ◽  
Suman Kushwaha ◽  
...  
Keyword(s):  
Spinal Tuberculosis ◽  
Surgical Decompression ◽  
Vertebral Collapse ◽  
Pott’S Disease ◽  
Dorsal Spinal

scholarly journals Evaluation of Outcome of Transpedicular Decompression and Instrumented Fusion in Thoracic and Thoracolumbar Tuberculosis

2017 ◽  
Vol 11 (1) ◽  
pp. 31-36 ◽  
Author(s):  
Akshay Jain ◽  
R.K. Jain ◽  
Vivek Kiyawat
Keyword(s):  
Back Pain ◽  
Pedicle Screws ◽  
Direct Access ◽  
Instrumented Fusion ◽  
Loss Of Correction ◽  
Vas Score ◽  
Transpedicular Approach ◽  
Thoracolumbar Region ◽  
Radiological Healing

<sec><title>Study Design</title><p>Retrospective analysis.</p></sec><sec><title>Purpose</title><p>We evaluated the functional, neurological, and radiological outcome in patients with thoracic and thoracolumbar tuberculosis operated through the transpedicular approach.</p></sec><sec><title>Overview of Literature</title><p>For surgical treatment of thoracic and thoracolumbar tuberculosis, the anterior approach has been the most popular because it allows direct access to the infected tissue, thereby providing good decompression. However, anterior fixation is not strong, and graft failure and loss of correction are frequent complications. The transpedicular approach allows circumferential decompression of neural elements along with three-column fixation attained via pedicle screws by the same approach.</p></sec><sec><title>Methods</title><p>A total of 47 patients were diagnosed with tuberculosis of the thoracic or thoracolumbar region from August 2012 to August 2013. Of these, 28 patients had progressive neurological deterioration or increasing back pain despite conservative measures and underwent transpedicular decompression and pedicle screw fixation with posterior fusion. Antituberculosis therapy was given till signs of radiological healing were evident (9–16 months). Functional outcome (visual analog scale [VAS] score for back pain), neurological recovery (Frankel grading), and radiological improvement were evaluated preoperatively, immediate postoperatively, and at 3 months, 6 months, and 1 year.</p></sec><sec><title>Results</title><p>Mean VAS score for back pain improved from 8.7 preoperatively to 1.1 at 1 year follow-up. Frankel grading preoperatively was grade B in 7, grade C in 11, and Grade D in 10 patients, which improved to grade D in 6 and grade E in 22 patients at the last follow-up. Radiological healing was evident in the form of reappearance of trabeculae formation, resolution of pus, fatty marrow replacement, and bony fusion in all patients. Mean correction of segmental kyphosis postoperatively was 10.5°. Mean loss of correction at final follow-up was 4.1°.</p></sec><sec><title>Conclusions</title><p>Transpedicular decompression with instrumented fusion is a safe and effective approach for management of patients with thoracic and thoracolumbar tuberculosis.</p></sec>

scholarly journals Biomechanical Comparison of Three Kinds of Minimally Invasive Internal Fixation in the Treatment of Pelvic Bilateral Anterior Ring Fractures

2020 ◽  
Author(s):  
Yong Zhao ◽  
Yupeng Ma ◽  
Dexin Zou ◽  
Xiujiang Sun ◽  
Gong Cheng ◽  
...  
Keyword(s):  
Element Model ◽  
Pelvic Injury ◽  
Hip Joints ◽  
Posterior Displacement ◽  
System Combination ◽  
Rod System ◽  
Anterior Ring ◽  
Fracture Stability ◽  
Intramedullary Screw ◽  
Anterior Posterior

Abstract [Objective] To compare the mechanical characteristics of percutaneous long plate, percutaneous pubic superioris intramedullary screw and percutaneous pelvic anterior screw-rod system for the treatment of bilateral vertical pubic fractures to provide reference for clinical application. [Methods] A finite element model of pelvic anterior ring injury (bilateral vertical pubic fracture) was produced. The fractures were fixed with percutaneous long plate, percutaneous pubic superioris intramedullary screw, percutaneous pelvic anterior screw-rod system and their combination in 5 types of models. The fracture stability under vertical, bilateral and anterior-posterior load were quantified and compared based on the displacement of the hip joints’ midpoint as quantificational index of fracture stability. [Results] In condition of bilateral and anterior-posterior load, the vertical, bilateral and anterior-posterior displacement of the hip joints’ midpoint of different models were significantly different respectively. In general, the displacement of the 5 pelvic anterior ring fixation models were ranked from maximum to minimum as follows: long plate, pelvic anterior screw-rod system, combination of long plate and pelvic anterior screw-rod system, pubic superioris intramedullary screw and combination of pubic superioris intramedullary screw and pelvic anterior screw-rod system. [Conclusion] For the fixation in bilateral pubic fractures of pelvic injury, the percutaneous pubic superioris intramedullary screw was optimal, percutaneous pelvic anterior screw-rod system was the second choice, and percutaneous long plate ranked the third. The percutaneous pelvic anterior screw-rod system can significantly increase fixation stability of the percutaneous pubic superioris intramedullary screw and the percutaneous long plate.

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