title: Surgical treatment of spinal tuberculosis complicated with extensive abscess.
abstract: OBJECTIVE
  Tuberculosis can be responsible for extensive spinal lesions. Despite the efficacy of medical treatment, surgery is indicated to avoid or correct significant deformity, treat spinal instability, prevent neurological compromise, and to eradicate an extensive tuberculous abscess. In this paper we present our experience in the surgical management of spinal tuberculosis complicated with large abscess.
  
  
  METHODS
  Fifteen patients with spinal tuberculosis complicated with extensive abscess were identified; and nine of those patients had extension of the infection into the epidural space. The average age at treatment was 34 years old. Seven patients had thoracic infection, seven patients had lumbar infection and one had thoracolumbar infection. Six patients had neurological deficit at presentation. All patients were surgically treated with abscess debridement, spinal stabilization and concurrent antituberculous chemotherapy. A single anterior surgical approach was used in three cases, a posterior approach was used in four others and a combined approach was performed in eight patients.
  
  
  RESULTS
  Surgical management allowed for effective abscess debridement and sspinal stabilization in this cohort. In combination with antituberculous drugs, surgical treatment resulted in infection eradication and bone fusion in all patients at 24 month average follow-up. Satisfactory neurological outcomes with improved American Spinal Injury Association (ASIA) scores were observed in 100% of patients.
  
  
  CONCLUSIONS
  Surgical treatment for spinal tuberculosis abscess can lead to satisfactory clinical outcomes.
authors.affiliation: Orthopaedic and Trauma Resident.
authors.forename: Joaquim
authors.initials: J
authors.lastname: Soares Do Brito
authors.affiliation: Orthopaedic and Trauma Specialist.
authors.forename: António
authors.initials: A
authors.lastname: Tirado
authors.affiliation: Head of Spine Surgery Unit.
authors.forename: Pedro
authors.initials: P
authors.lastname: Fernandes
mesh_terms: D000038:Abscess / Q000150:complications / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D003646:Debridement; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000150:complications / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D013904:Thoracic Vertebrae / Q000601:surgery; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents