Minimally invasive outpatient management of iliopsoas muscle abscess in complicated spondylodiscitis  

作　　者：Vasiliki Fesatidou Evangelos Petsatodis Dimitrios Kitridis Panagiotis Givissis Efthimios Samoladas 

机构地区：[1]4^(th)Department of General Surgery,Aristotle University of Thessaloniki,School of Medicine,Thessaloniki 54124,Greece [2]Department of Interventional Radiology,Papanikolaou General Hospital of Thessaloniki,Thessaloniki 57010,Greece [3]1^(st)Orthopaedic Department,Aristotle University of Thessaloniki,School of Medicine,Thessaloniki 54124,Greece

出　　处：《World Journal of Orthopedics》2022年第4期381-387,共7页世界骨科杂志（英文版）

摘　　要：BACKGROUND Iliopsoas muscle abscess(IPA)and spondylodiscitis are two clinical conditions often related to atypical presentation and challenging management.They are both frequently related to underlying conditions,such as immunosuppression,and in many cases they are combined.IPA can be primary due to the hematogenous spread of a microorganism to the muscle or secondary from a direct expansion of an inflammatory process,including spondylodiscitis.Computed tomographyguided percutaneous drainage has been established in the current management of this condition.AIM To present a retrospective analysis of a series of 8 immunocompromised patients suffering from spondylodiscitis complicated with IPA and treated with percutaneous computed tomography-guided drainage and drain insertion in an outpatient setting.METHODS Patient demographics,clinical presentation,underlying conditions,isolated microorganisms,antibiotic regimes used,abscess size,days until the withdrawal of the catheter,and final treatment outcomes were recorded and analyzed.RESULTS All patients presented with night back pain and local stiffness with no fever.The laboratory tests revealed elevated inflammatory markers.Radiological findings of spondylodiscitis with unilateral or bilateral IPA were present in all cases.Staphylococcus aureus was isolated in 3 patients and Mycobacterium tuberculosis in 2 patients.Negative cultures were found in the remaining 3 patients.The treatment protocol included percutaneous computed tomographyguided abscess drainage and drain insertion along with a course of targeted or empiric antibiotic therapy.All procedures were done in an outpatient setting with no need for patient hospitalization.CONCLUSION The minimally invasive outpatient management of IPA is a safe and effective approach with a high success rate and low morbidity.

关 键 词：Iliopsoas abscess SPONDYLODISCITIS Percutaneous drainage Minimally invasive OUTPATIENT IMMUNOCOMPROMISED 

分 类 号：R685[医药卫生—骨科学]