Tuberculose vertebral: análise descritiva de uma série de casos submetidos a tratamento cirúrgico

Schettino, Luiz Cláudio; Carelli, Luís Eduardo; Barbosa, Marcello Oliveira

doi:10.1590/s1808-18512010000200006

Cited by 3 publications

(3 citation statements)

References 9 publications

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“…4 Without treatment, progression to an esthetically significant deformity and neurological deficit are common outcomes. 5,6 The primary objectives of surgery in vertebral TB are drainage of the abscess with removal of the necrotic tissue, anterior decompression of the spinal cord, and stabilization of the spine and, secondarily, correction of the kyphotic deformity to prevent the development of paraplegia, as well as cosmetic improvement and improvement of lung function and of pain associated with the costo-pelvic impact. In cases of severe deformity, vertebrectomy is an appropriate technique that makes circumferential decompression and correction of kyphosis possible.…”

Section: Introductionmentioning

confidence: 99%

Posterior Vertebral Column Resection in Multiple Levels in Children With Vertebral Tuberculosis

et al. 2019

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Objective: To evaluate the clinical and radiological results of posterior vertebral column resection in the treatment of kyphosis due to vertebral tuberculosis in children under 9 years of age with neurological deficit. Methods: Retrospective study of a series of 5 cases, 4 females and 1 male, mean age of 4.7 years at the time of surgery, with spinal tuberculosis and mean kyphosis of 89 degrees. Results: All patients underwent surgical treatment with PVCR in multiple levels, with a mean number of 3.6 resected vertebrae, mean surgical time of 359 minutes, mean postoperative stay of 21.2 days. The mean follow-up was 29 months. The mean kyphosis correction was 62.6%. Before surgery, all patients had signs of spinal cord injury, one of which did not present a deficit of strength or sensibility (ASIA E), but there were pyramidal signs and a history of falls. The other 4 had some degree of sensory-motor dysfunction, with ASIA score varying from A to D. Postoperative complications included two dehiscences of suture, one pneumothorax and one pneumonia, all with favorable evolution. Four patients progressed with neurological improvement and one of them had persistence of the neurological deficit until the last follow-up. Conclusions: Multiple-level PVCR has proven to be a safe and effective option for the treatment of kyphotic deformity in spinal tuberculosis in children with neurological deficit. Level of evidence IV; Case Series. RESUMOObjetivo: Avaliação dos resultados clínicos e radiológicos da vertebrectomia posterior multinível no tratamento da cifose por tuberculose vertebral em crianças menores de 9 anos apresentando déficit neurológico. Métodos: Estudo retrospectivo de uma série de 5 casos, sendo 4 do sexo feminino e 1 do sexo masculino, média de idade de 4,7 anos na época da cirurgia, portadoras de tuberculose vertebral múltiplos níveis, com média de cifose de 89°. Resultados: Todos os pacientes foram submetidos ao tratamento cirúrgico com RCVP múltiplos níveis, com número médio de 3,6 vértebras ressecadas, média de tempo cirúrgico de 359 minutos, período médio de internação pós-operatória de 21,2 dias. O seguimento médio foi de 29 meses. A média de correção da cifose foi de 62,6%. Antes da cirurgia, todos os pacientes tinham sinais de sofrimento medular, sendo que um deles não apresentava déficit de força ou sensibilidade (ASIA E), porém havia a presença de sinais piramidais e história de quedas. Os outros 4 possuíam algum grau de disfunção sensitivo-motora, com escore ASIA variando de A a D. Como complicações pós-operatórias ocorreram duas deiscências de sutura, um pneumotórax e uma pneumonia, todas com evolução favorável. Quatro pacientes evoluíram com melhora neurológica e um deles apresentou manutenção do déficit neurológico até o último seguimento. Conclusão: A RCVP múltiplos níveis se mostrou uma opção segura e eficaz no tratando da cifose na TB vertebral em crianças com déficit neurológico. Nível de evidência IV; Série de Casos. Descritores: Tuberculose da Coluna Vertebral; Compressão da Medula Espinhal;...

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Section: Introductionmentioning

confidence: 99%

Posterior Vertebral Column Resection in Multiple Levels in Children With Vertebral Tuberculosis

et al. 2019

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“…As alterações posturais consistem em modificações no alinhamento corporal, produzindo um excesso de tensão muscular, que muitas vezes surgem por compensações, ou seja, o corpo faz adaptações para compensar um quadro álgico ou devido a tensões musculares. Essas adaptações geram mais tensões musculares que, se persistirem, favorecem o desenvolvimento de mais deformidades (4) . O diagnóstico da tuberculose deve ser sempre precedido pela anamnese, por um exame físico e pela radiografia de tórax, que pode auxiliar no diagnóstico da maioria dos casos.…”

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Métodos McKenzie E Isotretching Na Tuberculose Lombar: Relato De Caso

França¹,

Veloso²,

Lobo³

et al. 2012

Rev. Bras. Ciên. Saúde

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The bone tuberculosis is triggered by the spread of Mycobacterium tuberculosis by hematogenous, the local development of the disease is the cancellous bone of the vertebral bodies, the infection spreads to neighboring levels through the anterior and posterior longitudinal ligaments postural changes consist of modifications alignment body, producing an excessive muscular tension, which often appear by compensation, to prevent or treat such changes, the use of techniques such as isostretching and McKenzie that prepares and protects the muscles of the column and limbs in order to avoid adaptation to compensate for a painful picture may influence the functional independence, quality of life and pain. Objectives: to present the clinical case of a patient affected by tuberculosis in the lumbar spine treated in physiotherapy by Isostretching and McKenzie methods in order to improve motor function, pain and health profile. Case Description: a female patient, 44 years referred to the Department of Physical Therapy at the Hospital of the Federal University of Sergipe, with clinical diagnosis of lumbar tuberculosis by means of MRI shows bone destruction of L4-L5 vertebral plateaus and purified protein derivative (PPD) 25 mm, suggestive of tuberculosis, weight loss, daily fever for 2 months, pain in the hip area and ilium character constant, paraparesis with preservation of sensitivity and functional changes. Ten physical therapy visits were carried out using the isostretching and McKenzie methods, once a week as measured by the Functional Independence Measure (FIM), Visual Analogue Scale (VAS), Nottingham Health Profile (NHP). The FIM ranged from 18 to 105, VAS 10 to 3 and NHP 100 to 34. Results: after conservative treatment the patient had decreased pain symptoms, greater functional dependence and improved quality of life.

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“…This refers to the infection of one or more vertebral bodies by Mycobacterium tuberculosis with or without involvement of the spinal canal 2,3 . It occurs as a result of the hematogenous spread or erosion of adjacent caseating lymphnodes after a primary pulmonary infection that is not generally evident in children as they are more vulnerable to the occurrence of discitis because of the persistence of the anastomosis between the motor endplate and the spinal disc 4 .…”

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Bone tuberculosis: a case report on child

Santos

Nascimento

Lira

et al. 2013

Rev. Soc. Bras. Med. Trop.

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The authors report a case of a 12-year-old child with a complaint of pain and deformity in the lower thoracic region that had lasted for two years. Clinical, epidemiological and laboratory characteristics associated with images of apparent damage in the T9-T10 and T11-T12 vertebrae taken by radiography of the thoracic spine and nuclear magnetic resonance in addition to the positivity of the molecular test based on the polymerase chain reaction, led to tuberculous spondylitis being diagnosed and specific therapy was started. Culture of vertebral biopsy was positive for Mycobacterium tuberculosis after thirty days.

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Tuberculose vertebral: análise descritiva de uma série de casos submetidos a tratamento cirúrgico

Cited by 3 publications

References 9 publications

Posterior Vertebral Column Resection in Multiple Levels in Children With Vertebral Tuberculosis

Posterior Vertebral Column Resection in Multiple Levels in Children With Vertebral Tuberculosis

Métodos McKenzie E Isotretching Na Tuberculose Lombar: Relato De Caso

Bone tuberculosis: a case report on child

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