Comparison of the Anteroposterior and Posterior Approaches for Percutaneous Catheter Drainage of Tuberculous Psoas Abscess

BACKGROUND Tuberculous infection of the lumbar spine may be associated with psoas abscess. The aim of this clinical study was to compare the outcome of posterior lumbar debridement and spinal fusion, combined with either a one-stage anteroposterior (AP) or posterior (P) approach to percutaneous catheter drainage (PCD) for the treatment of lumbar tuberculosis with psoas abscess. MATERIAL AND METHODS From January 2008 to June 2012, 74 patients were diagnosed at our hospital with lumbar tuberculosis with unilateral or bilateral psoas abscess. Forty-three patients underwent P-PCD (group A), and 31 patients underwent AP-PCD (group B). Operative duration, blood loss, the length of hospital stay, spinal correction, clinical cure rate, and other clinical outcomes in the two groups were compared. RESULTS Comparison of the outcome for the P-PCD and AP-PCD patients showed that there was no significant difference in outcome for spinal bone fusion, correction of spinal deformity, or cure rate from tuberculosis infection (P>0.05). Blood loss, operative time, and the length of hospital stay for patients in group A, the P-PCD group, were significantly less than for group B, the AP-PCD group (P<0.05). Also, group B, the AP-PCD group, had an increased incidence of complications than group A, the P-PCD group, leading to increased hospital stay (OR 3.04, CI 0.52-17.75). CONCLUSIONS For the treatment of tuberculous psoas abscess using PCD, the posterior approach may achieve the same clinical efficacy as the anteroposterior approach, but is associated with reduced length of hospital stay, and lower risk of complications.