[Successful surgical intervention for lumbar tuberculous spondylodiscitis in spite of delayed indication - 5 year follow-up].
Tuberculosis constitutes an important clinical entity with 90 million new infections worldwide during the last decade. 10 % of these infections affect osseous structures based on haematogenous spread. Therefore, tuberculous spondylodiscitis remains a major illness in orthopaedics which needs to be considered in cases of unspecific back pain. Pathognomonic characteristics are absent and clinical, chemical and radiological parameters are not reliable. The consequences of a delayed surgical intervention are discussed based on a case report with 5 year follow-up. Both adequate early CT and MRI scans and identification of the pathogen are essential in order to plan the therapy. Final re-evaluation of a conservative treatment regime needs to be done no later than six to eight weeks depending on the clinical constellation. Persistent or progressive spondylodiscitis with osseous destructions or neurological deficits demands a radical surgical intervention.
Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Aachen. christianspies1@gmx.net
C K G
CK
Spies
J A K
JA
Ohnsorge
M
M
Weisskopf
D000328:Adult; D000995:Antitubercular Agents / Q000009:adverse effects / Q000627:therapeutic use; D003937:Diagnosis, Differential; D015299:Discitis / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D004322:Drainage; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D009460:Neurologic Examination; D019919:Prosthesis Implantation; D016659:Psoas Abscess / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D012086:Reoperation; D013123:Spinal Fusion; D014057:Tomography, X-Ray Computed; D014399:Tuberculosis, Spinal / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*
D000995:Antitubercular Agents