CC BY-NC-ND 4.0 · Asian J Neurosurg 2023; 18(02): 327-332
DOI: 10.1055/s-0042-1748788
Case Report

Bilateral Percutaneous Transpedicular Drainage under Local Anesthesia for Thoracic Tuberculous Spondylitis

Yoshinori Maki
1   Department of Neurosurgery, Hikone Chuo Hospital, Shiga, Japan
2   Department of Rehabilitation, Hikari Hospital, Shiga, Japan
Motohiro Takayama
3   Department of Neurosurgery, Otsu City Hospital, Shiga, Japan
Kohichi Go
3   Department of Neurosurgery, Otsu City Hospital, Shiga, Japan
› Author Affiliations


Tuberculous spondylitis is a common spinal infection. If surgical intervention is necessary, anterior debridement and anterior fixation are typically performed. However, a minimally invasive surgical strategy under local anesthesia seems rarely implemented.

A 68-year-old man presented with severe pain in the left flank. Whole spinal magnetic resonance imaging revealed abnormal intensity of vertebral bodies from T6–9. A bilateral paravertebral abscess extending from T4–10 was suspected. The T7/T8 intervertebral disc was destroyed, but severe vertebral deformity or spinal cord compression was not observed. Bilateral percutaneous transpedicular drainage under local anesthesia was planned. The patient was set in the prone position. Under the guide of a biplanar angiographic system, the bilateral drainage tubes were placed paravertebrally in the abscess cavity. The left flank pain improved after the procedure. Laboratory culture of the pus specimen confirmed a diagnosis of tuberculosis. A chemotherapy regimen for tuberculosis was soon initiated. The patient was discharged during postoperative week 2, with continuation of chemotherapy for tuberculosis.

Percutaneous transpedicular drainage under local anesthesia can be effective in the management of thoracic tuberculous spondylitis without severe vertebral deformity or compression of the spinal cord by an abscess.

Authors' Contributions

Y.M. contributed in drafting the article. M.T. contributed in revising the article critically and final approval of the manuscript to be submitted. K.G. contributed in the conception and design of the study and acquisition of data.

Publication History

Article published online:
16 June 2023

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