Objective To investigate the value of Hounsfield units (HUs) as an independent predictor of failed percutaneous drainage of spinal tuberculosis paraspinal abscess under computed tomography (CT) guidance.
Methods A retrospective analysis was conducted on 61 patients who underwent CT-guided percutaneous drainage for spinal tuberculosis paraspinal abscess between October 2017 and October 2020. Preoperative CT scans were used to measure the HUs of the abscess. Patients were categorized into successful drainage (n = 49) and failed drainage (n = 12) groups. Statistical analysis involved independent sample t-tests and chi-square tests to compare between the 2 groups. Binary logistic regression was performed to identify independent predictive factors for drainage failure. Receiver operating characteristic (ROC) curves were employed to ascertain risk factor thresholds and diagnostic performance.
Results Among the patients, 49 experienced successful drainage while 12 faced drainage failure. The mean HUs of abscesses in the failed drainage group were significantly higher than those in the successful drainage group (p < 0.001). ROC analysis revealed an area under the curve of 0.897 (95% confidence interval, 0.808–0.986) for predicting drainage failure based on HUs. The optimal HU cutoff value for predicting drainage failure was 22.3, with a sensitivity of 91.7% and specificity of 69.4%.
Conclusion HUs are an independent predictor of failed percutaneous drainage of spinal tuberculosis paraspinal abscess under CT guidance. The HU value of 22.3 can be used as an initial screening threshold for predicting the success or failure of drainage.
Citations
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A novel clinical classification of spinal tuberculosis for decision-making guidelines from Chinese spine surgeons: a multicenter retrospective cohort study Hui Lv, Zhengqi Chang, Litao Li, Qiang Zhang, Hongdong Tan, Jiezhong Deng, Jinyue He, Yu Xiang, Hui Chen, Sheng Liao, Yanzhu Lu, Zhongrong Zhang, Qile Gao, Shibing Qin, Jianzhong Xu, Zehua Zhang International Journal of Surgery.2026; 112(2): 4152. CrossRef
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Objective To illustrate a simultaneous single-position oblique lateral interbody fusion (SPOLIF) combined with unilateral percutaneous pedicle screw fixation in treating single-level lumbar tuberculosis, compared with posterior-only approach in clinical and radiographic evaluations.
Methods Consecutive patients who had undergone surgeries for single-level lumbar tuberculosis from January 2018 to December 2020 were retrospectively reviewed. The patients included were divided into SP-OLIF and posterior-only groups according to surgical methods applied, with follow-up for at least 36 months. Outcomes included estimated blood loss, operative time, and complications for safety evaluation; visual analogue scale (VAS), Oswestry Disability Index (ODI) for efficacy evaluation; erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) for evaluating tuberculosis activity; x-ray and computed tomography scan were used for radiographic evaluation.
Results A total of 136 patients had been enrolled in the study (60 for SP-OLIF and 76 for Posterior-only). The median operative time, blood loss, and hospital stay in SP-OLIF group were significantly less, with a lower complication rate. Meanwhile, the SP-OLIF group showed substantially lower VAS in 1 and 7 days and decreased ODI in the first month postoperatively, without significant difference afterward. Similarly, the median CRP and ESR in SP-OLIF group were significantly lower in 3 and 7 days postoperatively. All indicators had reduced to normal after 3 months. No recurrence had been reported throughout the whole follow-up.
Conclusion SP-OLIF was an efficient minimally invasive protocol for single-level lumbar tuberculosis, facilitating earlier clinical improvement, with decreased blood loss, operative time and hospital stay compared with posterior-only approach.
Citations
Citations to this article as recorded by
A novel clinical classification of spinal tuberculosis for decision-making guidelines from Chinese spine surgeons: a multicenter retrospective cohort study Hui Lv, Zhengqi Chang, Litao Li, Qiang Zhang, Hongdong Tan, Jiezhong Deng, Jinyue He, Yu Xiang, Hui Chen, Sheng Liao, Yanzhu Lu, Zhongrong Zhang, Qile Gao, Shibing Qin, Jianzhong Xu, Zehua Zhang International Journal of Surgery.2026; 112(2): 4152. CrossRef
Biomechanical evaluation of a novel L-shaped side-locking plate combined with OLIF: a finite element analysis considering 3 different bone densities Zemin Wang, Lijun Wang, Honglai Zhang, Wei Guo, Wei Yang, Wanzhong Yang, Shiyong Wang, Rong Ma, Zhaohui Ge Frontiers in Surgery.2026;[Epub] CrossRef
Editorial: Characterization and differential diagnosis of host immunity in patients with bone infections and bone tumors Zehua Zhang, Qile Gao, Kun Xiong Frontiers in Immunology.2025;[Epub] CrossRef
Uniportal endoscopic decompression and debridement for infectious diseases of spine with neurological deficits: a retrospective study in China Hui Lv, Jianhong Zhou, Yuan Guo, Sheng Liao, Hui Chen, Fei Luo, Jianzhong Xu, Zhongrong Zhang, Zehua Zhang Asian Spine Journal.2025; 19(2): 205. CrossRef
Biomechanical evaluation of various fixation strategies in oblique lumbar interbody fusion: a finite element analysis Jinyue He, Jiezhong Deng, Yu Xiang, Yusheng Yang, Sheng Liao, Hui Chen, Fei Luo, Jianzhong Xu, Zhongrong Zhang, Zehua Zhang BMC Musculoskeletal Disorders.2025;[Epub] CrossRef
From the Editor-in-Chief: Featured Articles in the December 2023 Issue Inbo Han Neurospine.2023; 20(4): 1093. CrossRef
Commentary on “Simultaneous Single-Position Oblique Lateral Interbody Fusion Combined With Unilateral Percutaneous Pedicle Screw Fixation for Single-Level Lumbar Tuberculosis: A 3-Year Retrospective Comparative Study” Chao-Hung Kuo, Tsung-Hsi Tu Neurospine.2023; 20(4): 1319. CrossRef
Objective To evaluate the clinical and radiological efficacy of a combine of lateral single screw-rod and unilateral percutaneous pedicle screw fixation (LSUP) for lateral lumbar interbody fusion (LLIF) in the treatment of spondylolisthesis.
Methods Sixty-two consecutive patients with lumbar spondylolisthesis who underwent minimally invasive (MIS)-TLIF with bilateral pedicle screw (BPS) or LLIF-LSUP were retrospectively studied. Segmental lordosis angle (SLA), lumbar lordosis angle (LLA), disc height (DH), slipping percentage, the cross-sectional areas (CSA) of the thecal sac, screw placement accuracy, fusion rate and foraminal height (FH) were used to evaluate radiographic changes postoperatively. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were used to evaluate the clinical efficacy.
Results Patients who underwent LLIF-LSUP showed shorter operating time, less length of hospital stay and lower blood loss than MIS-TLIF. No statistical difference was found between the 2 groups in screw placement accuracy, overall complications, VAS, and ODI. Compared with MIS-TLIF-BPS, LLIF-LSUP had a significant improvement in sagittal parameters including DH, FH, LLA, and SLA. The CSA of MIS-TLIF-BPS was significantly increased than that of LLIF-LSUP. The fusion rate of LLIF-LSUP was significantly higher than that of MIS-TLIF-BPS at the follow-up of 3 months postoperatively, but there was no statistical difference between the 2 groups at the follow-up of 6 months, 9 months, and 12 months.
Conclusion The overall clinical outcomes and complications of LLIF-LSUP were comparable to that of MIS-TLIF-BPS in this series. Compared with MIS-TLIF-BPS, LLIF-LSUP for lumbar spondylolisthesis represents a significantly shorter operating time, hospital stay and lower blood loss, and demonstrates better radiological outcomes to maintain lumbar lordosis, and reveal an overwhelming superiority in the early fusion rate.
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Progress in Minimally Invasive Treatment of Degenerative Lumbar Spondylolisthesis 玺 梅 Advances in Clinical Medicine.2024; 14(02): 3543. CrossRef
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