Author/Authors :
OliveirA de ArAujO, Alex Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (IOT-HCFMUSP) - Instituto de Ortopedia e Traumatologia - Spine Surgery Division, São Paulo, SP, Brazil , QueirOz SOAreS, ThiAgO Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (IOT-HCFMUSP) - Instituto de Ortopedia e Traumatologia - Spine Surgery Division, São Paulo, SP, Brazil , gOnzAlez TOrelli, AleSSAndrO Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (IOT-HCFMUSP) - Instituto de Ortopedia e Traumatologia - Spine Surgery Division, São Paulo, SP, Brazil , hirOShi de ArAujO OnO, AllAn Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (IOT-HCFMUSP) - Instituto de Ortopedia e Traumatologia - Spine Surgery Division, São Paulo, SP, Brazil , MArTuS MArcOn, rAphAel Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (IOT-HCFMUSP) - Instituto de Ortopedia e Traumatologia, Laboratory of Medical Investigation - Spine Surgery Division, São Paulo, SP, Brazil. , FOgAçA criSTAnTe, AlexAndre Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (IOT-HCFMUSP) - Instituto de Ortopedia e Traumatologia, Laboratory of Medical Investigation - Spine Surgery Division, São Paulo, SP, Brazil. , elOy peSSOA de BArrOS FilhO, TArcíSiO Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (IOT-HCFMUSP) - Instituto de Ortopedia e Traumatologia - Spine Surgery Division, São Paulo, SP, Brazil
Abstract :
Objective: To describe a case of disseminated tuberculosis
affecting the lumbar spine that was treated using a non-con-
ventional anterior support system. Background: Tuberculous
spondylodiscitis is the most common and most severe form of
extrapulmonary tuberculosis. Although antibiotic therapy is the
most frequently used treatment, surgery is necessary in cases
of neurological deficit, spinal instability, significant deformity,
severe sepsis, paravertebral and epidural abscesses or in cases
wherein clinical treatment has failed. A surgical procedure is
also indicated when a biopsy is required. With the development
of new methods for reconstruction and fixation of the spine,
complete debridement of the tuberculous foci has become an
increasingly common approach, but there is a lack consen-
sus on the best technique. Methods and results: The patient
suffered from disseminated tuberculosis affecting the lumbar
region of the spine, with an abscess in the psoas muscle. He
underwent extensive debridement via both anterior and posterior
approaches, using a non-conventional anterior support system
that promotes hydrostatic distraction. Conclusions: Treatment
using the hydrostatic distraction system was able to reestablish
both the stability and anatomy of the lumbar curve. Level of
evidence IV, Case report.
Keywords :
Spinal tuberculosis , Osteoarticular tuberculosis , De- bridement , Surgical procedures