Tuberculosis surgery: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
No edit summary |
||
Line 35: | Line 35: | ||
* Gross instabillity and neurological complications are treated by decompression and fusion of the anterior segments. | * Gross instabillity and neurological complications are treated by decompression and fusion of the anterior segments. | ||
* Joint damage may be repaired by late surgery and arthrodosis. | * Joint damage may be repaired by late surgery and arthrodosis. | ||
The main stay of treatment for skeletal tuberculosis is antibiotics and surgery. The selection of antibiotics for skeletal tuberculosis is the same as that of pulmonary tuberculosis. <ref name=Tuberculosis>{{cite web | title = tech ortho TB| url = http://www.global-help.org/publications/articles/techortho_tuberculosismusculoskeletal.pdf }}</ref> | |||
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center | |||
|valign=top| | |||
|+ | |||
! style="background: #4479BA; width: 250px;" | {{fontcolor|#FFF|Stage}} | |||
! style="background: #4479BA; width: 350px;" | {{fontcolor|#FFF|Treatment}} | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Stage 1 (synovitis) | |||
| style="padding: 5px 5px; background: #F5F5F5;" |<br> Chemotherapy<br> Rest<br> Restriction of movements<br> Splinting | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |Stage 2 (Early arthritis) | |||
| style="padding: 5px 5px; background: #F5F5F5;" |<br> Chemotherapy<br> Rest<br> Restriction of movements<br> Splinting<br> Synovectomy | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |Stage 3 (Advanced arthritis) | |||
| style="padding: 5px 5px; background: #F5F5F5;|<br> Chemotherapy<br> Osteotomy<br> Arthrodesis<br> Arthroplasty | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |Stage 4 (Advanced arthritis) | |||
| style="padding: 5px 5px; background: #F5F5F5;"|<br> Chemotherapy<br> Osteotomy<br> Arthrodesis<br> Arthroplasty | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |Stage 5 | |||
| style="padding: 5px 5px; background: #F5F5F5;"|<br> Chemotherapy<br> Osteotomy<br> Arthrodesis<br> Arthroplasty | |||
|} | |||
Revision as of 18:33, 24 September 2014
Tuberculosis Microchapters |
Diagnosis |
---|
Treatment |
Case Studies |
Tuberculosis surgery On the Web |
American Roentgen Ray Society Images of Tuberculosis surgery |
Overview
Surgery may be necessary, especially to drain spinal abscesses or to stabilize the spine in case of Pott's disease.
Surgery
Renal tuberculosis
Surgery is necessary to remove the urinary obstruction in genito urinary tuberculosis. 3 most common sites which can cause urinary obstruction is as follows. [1]
- Pelvi- ureteral junction
- Calyx
- Lower end of ureter
Types of surgery | Proceedure |
---|---|
Cavernotomy | It involves removal of avascular caeseous material which helps in preventing complications like abscess rutputre. It has got excellent prognosis |
Partial nephrectomy | This was an old technique to remove the affected tissue. Recently the drug regimen helps to heal the calyx and hence partial nephrectomy is not widely practised now. |
Nephrectomy | Chief indication of nephrectomy is obstruction of pelvi-ureteric junction. Plastic surgery of pelvi uretric junction is also an option for it. Drianage improves the treatment |
Excsion of stricture and reimplantation of ureter into the bladder. | This is another conservative surgical management which has shown promising results. |
Spinal tuberculosis
- Biopsy is used to make a diagnosis.
- Gross instabillity and neurological complications are treated by decompression and fusion of the anterior segments.
- Joint damage may be repaired by late surgery and arthrodosis.
The main stay of treatment for skeletal tuberculosis is antibiotics and surgery. The selection of antibiotics for skeletal tuberculosis is the same as that of pulmonary tuberculosis. [2]
Stage | Treatment |
---|---|
Stage 1 (synovitis) | Chemotherapy Rest Restriction of movements Splinting |
Stage 2 (Early arthritis) | Chemotherapy Rest Restriction of movements Splinting Synovectomy |
Stage 3 (Advanced arthritis) | Chemotherapy Osteotomy Arthrodesis Arthroplasty |
Stage 4 (Advanced arthritis) | Chemotherapy Osteotomy Arthrodesis Arthroplasty |
Stage 5 | Chemotherapy Osteotomy Arthrodesis Arthroplasty |
References
- ↑ HANLEY HG (1963). "TREATMENT OF RENAL TUBERCULOSIS". Br Med J. 2 (5373): 1611–2. PMC 1873944. PMID 14066180.
- ↑ "tech ortho TB" (PDF).