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December 1960

Anterior Dependent Drainage for Tuberculous Lumbosacral Spinal Lesions: Coccygectomy and Dependent Drainage in Treatment of Tuberculous Lesions of the Lower Spine with Associated Soft-Tissue Abscesses

Author Affiliations

From the West Tennessee Tuberculosis Hospital.

Arch Surg. 1960;81(6):961-964. doi:10.1001/archsurg.1960.01300060107021

Introduction  Well-established soft-tissue abscesses and draining sinus tracts associated with tuberculous lesions of the spine may be very resistant to ordinary management and require prolonged hospitalization and treatment. Experience indicates that the most satisfactory therapy for tuberculous lesions of the spine with associated soft-tissue abscesses consists of adequate surgical drainage with debridement of the osseous and soft-tissue foci, under cover of effective chemotherapy and the usual tuberculous institutional care.1,2 The surgical approach to such lesions above the lumbar level presents no particular problem. However, in association with lesions of the lower lumbar vertebrae, one may encounter adjacent softtissue abscesses which have a tendency to gravitate downward forming a large abscess in the pelvis anterior to the sacrum. Many of these eventually point at skin level, frequently presenting on the anterior surface of the thigh or above the iliac crest, and drain spontaneously or are surgically incised locally. This inadequate