دورية أكاديمية
Medical management of Pott disease in the thoracic and lumbar spine: a prospective clinical study.
| العنوان: | Medical management of Pott disease in the thoracic and lumbar spine: a prospective clinical study. |
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| المؤلفون: | Kotil K; Department of Neurosurgery, Haseki Education and Research Hospital, Istanbul, Turkey. kadirkotil@superonline.com, Alan MS, Bilge T |
| المصدر: | Journal of neurosurgery. Spine [J Neurosurg Spine] 2007 Mar; Vol. 6 (3), pp. 222-8. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: American Association of Neurological Surgeons Country of Publication: United States NLM ID: 101223545 Publication Model: Print Cited Medium: Print ISSN: 1547-5654 (Print) Linking ISSN: 15475646 NLM ISO Abbreviation: J Neurosurg Spine Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Charlottesville, VA : American Association of Neurological Surgeons, c2004- |
| مواضيع طبية MeSH: | Antitubercular Agents/*therapeutic use , Tuberculosis, Spinal/*drug therapy, Adolescent ; Adult ; Aged ; Child ; Drug Therapy, Combination ; Female ; Humans ; Lumbar Vertebrae ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Prognosis ; Prospective Studies ; Thoracic Vertebrae ; Treatment Outcome ; Tuberculosis, Spinal/diagnosis |
| مستخلص: | Object: The aim of this study was to evaluate conservative medical management of 44 patients with Pott disease. The prognostic significance of various clinical, radiological, and long-term follow-up findings in these patients was also evaluated. Methods: Between January 1990 and January 2005 data were collected prospectively at the authors' clinic in 44 patients with Pott disease in the thoracic or lumbar spine. These patients had no major neurological deficits or severe spinal deformities. The study population consisted of 21 male (48%) and 23 female (52%) patients, with a mean age of 42.1 years (range 10-70 years). The most common region of Pott disease was the thoracolumbar junction (18 cases; 41%), followed by the thoracic (16 cases; 36%) and lumbar (10 cases; 23%) regions. All patients presented with abscesses. With the exception of two cases, all had kyphotic angles smaller than 30 degrees. At presentation, 20 patients had neurological signs of spinal cord compression during clinical examination. Both clinical and biopsy findings were used in all cases for diagnosis. A diagnosis was confirmed by a positive biopsy specimen culture in 19 (43.2%) of 44 cases, and histopathological findings were compatible with the results of these cultures in all cases. All patients were treated with antituberculous chemotherapy, and the diseases in only two (4.5%) was resistant to the regimen. An independent observer assessed the clinical and imaging findings after a mean follow-up duration of 40 months. Forty-two (95.4%) of the 44 patients were successfully treated with conservative medical management and attained acceptable spinal deformity angles, and none of these patients had any residual instability, radiculopathy, or neurological compromise. Only 4.5% of the patients experienced residual spine deformity (as much as a 30 degrees kyphotic angle), which was clinically obvious but biomechanically stable. Conclusions: Patients with Pott disease in the lumbar or thoracic region, without neurological deficits or kyphosis, can be treated conservatively in the vast majority of cases. Indications for surgery need to be redefined given these new data. |
| المشرفين على المادة: | 0 (Antitubercular Agents) |
| تواريخ الأحداث: | Date Created: 20070316 Date Completed: 20070403 Latest Revision: 20220419 |
| رمز التحديث: | 20240628 |
| DOI: | 10.3171/spi.2007.6.3.222 |
| PMID: | 17355021 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1547-5654 |
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| DOI: | 10.3171/spi.2007.6.3.222 |