关键词: 结核,脊柱, 胸椎, 脓肿, 引流术, 外科手术, 微创性

Abstract:

Objective: To evaluate the clinical efficacy and safety of CT-guided catheter drainage as an adjunctive treatment for thoracic spinal tuberculosis with paravertebral abscess. Methods: A retrospective analysis was conducted on 26 patients with thoracic spinal tuberculosis complicated by paravertebral abscess who were treated in the Department of Orthopedics, Beijing Chest Hospital, Capital Medical University, between January 2020 and July 2024. All patients underwent CT-guided catheter drainage under local anesthesia. Operative time, blood loss, drainage volume, and duration of drainage were recorded. Preoperative and postoperative body temperature, visual analogue scale (VAS) score, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels were compared. All patients were followed up for 12-24 months. Results: All 26 patients successfully underwent catheter drainage. The mean drainage duration was (4.8±2.3) days, and the total drainage volume ranged from 50 to 200 ml. The ESR decreased from a preoperative level of (49.8±20.4) mm/1 h to a postoperative level of (19.4±10.2) mm/1 h; CRP levels decreased from (20.9±9.6) mg/L preoperatively to (8.6±3.6) mg/L postoperatively; and the VAS score decreased from (7.5±1.8) preoperatively to (2.4±1.6) postoperatively, with all differences being statistically significant (t=3.464, 3.492, and 3.650, respectively; all P<0.001). No serious complications, such as major vascular injury, nerve injury, or sinus tract formation, were observed. During follow-up, all abscesses resolved, the extent of vertebral inflammation decreased, and no recurrence was observed. Conclusion: CT-guided catheter drainage is a safe, minimally invasive, and effective treatment for thoracic spinal tuberculosis with paravertebral abscess. It can reduce abscess burden, improve inflammatory markers and clinical symptoms, and may help decrease the invasiveness of subsequent surgical procedures. This technique is particularly suitable for patients in poor general condition or those who cannot tolerate thoracotomy, and has promising clinical application value.

Key words: Tuberculosis, spinal, Thoracic spine, Abscess, Drainage, Surgical procedures, minimally invasive