title: Percutaneous management of complications of tuberculous spondylodiscitis: short- to medium-term results.
abstract: OBJECTIVE
  Psoas abscesses are the most frequent complication of tuberculosis with skeletal involvement. The aim of this paper is to report our experience with the systematic application of percutaneous drainage to tuberculous psoas abscesses.
  
  
  METHODS
  Between January 1997 and December 2005, 23 patients (14 men and nine women; age range 21-48 years), after a previous study with computed tomography (CT) and/or magnetic resonance (MR) imaging, underwent percutaneous drainage of a tuberculous fluid collection in the psoas muscles. Follow-up consisted of monthly clinical and laboratory assessment, and plain chest radiography and spinal CT every 6-12 months.
  
  
  RESULTS
  Spondylodiscitis involved the thoracolumbar spine. Fluid collections were bilateral in 14 cases and communicating in ten of these. Maximum transverse diameter was 7 cm, whereas longitudinal diameter was 14 cm. Placement of the drainage catheter was successful in all cases, and the catheter was left in place for 5-36 (mean 18.4) days. Symptom regression occurred immediately after drainage of the fluid collection. The drainage procedure was curative in 100% of cases. Dislodgement of the drainage catheter occurred in two cases as a result of excessive traction during dressing removal.
  
  
  CONCLUSIONS
  A serious complication of bone tuberculosis, psoas abscesses, can be effectively treated by percutaneous drainage, leading to immediate pain resolution. The drainage catheter requires daily monitoring to identify when it can be safely removed without risk of recurrence.
authors: Radiologia Vascolare ed Interventistica, Rome, Italy. stepieri@excite.it
authors: S
authors: S
authors: Pieri
authors: P
authors: P
authors: Agresti
authors: A M
authors: AM
authors: Altieri
authors: P
authors: P
authors: Ialongo
authors: A
authors: A
authors: Cortese
authors: M G
authors: MG
authors: Alma
authors: L
authors: L
authors: de' Medici
mesh_terms: D000328:Adult; D003287:Contrast Media; D015299:Discitis / Q000150:complications*; D004322:Drainage / Q000379:methods*; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008159:Lumbar Vertebrae; D053783:Magnetic Resonance Imaging, Interventional; D008297:Male; D008875:Middle Aged; D016659:Psoas Abscess / Q000209:etiology* / Q000628:therapy*; D015641:Radiography, Interventional; D013904:Thoracic Vertebrae; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014283:Triiodobenzoic Acids; D014394:Tuberculosis, Osteoarticular / Q000150:complications*
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; D019786:Gadolinium DTPA; C054871:ioversol