Image-guided percutaneous drainage of tuberculous iliopsoas and spondylodiskitic abscesses:: Midterm results

PURPOSE: To evaluate midterm results of percutaneous drainage (PD) with image guidance in 21 patients with 1 tuberculous iliopsoas abscesses with or without spondylodiskitis. MATERIALS AND METHODS: Computed tomography (CT)-guided PD was performed in 21 patients with 26 tuberculous iliopsoas abscesses. Nineteen patients had bone involvement of two or more vertebrae. Eleven patients with spondylocliskitis had intradiskal abscesses. Five patients had bilateral psoas abscesses. Easily and safely accessible well-circumscribed abscesses larger than 3 cm were selected for PD. to the abscess cavities with Seldinger technique in all Catheters were inserted in cases. In conjunction with PD, all patients had antituberculous drug therapy and underwent clinical and imaging follow-up for at least 1 year. RESULTS: Percutaneous catheter placement was successful in all cases without procedural complications. On, the basis of CT findings, complete evacuation of all abscesses was achieved, initially. During follow-up, six (29%) of 21 patients had recurrences within 1 and 3 months after catheter removal. A total of 37 catheters were used; eight of the 37 catheters were inserted due to recurrences. Four patients two patients needed three due to recurrences. Four needed two PD procedures, and catheters were changed: because of obstruction or dislocation. Drainage duration ranged from 5 to 36 days (mean, 14.9 days). The follow-up period was 12-52 months (mean, 24 months). None of the patients, including those with recurrence, required surgical drainage, and, debridement due to insufficient PD. CONCLUSION: Image-guided PD in conjunction with antituberculous drug therapy is an effective and safe procedure in the treatment of tuberculous iliopsoas abscesses with or without spondylodiskitris. ((C)) RSNA, 2002.