Postoperative Recurrence Factors Of Spinal Tuberculosis COX Regression Analysis

Objective: To investigate the risk factors of postoperative recurrence of spinal tuberculosis and the relative degree of risk. As far as possible to avoid the occurrence of recurrence and improve the cure rate of surgical treatment of tuberculous spondylitis.Method: During January 1999 ~ August 2007, there were 316 cases with spinal tuberculosis (Pathological diagnosis), telephone and out-patient follow-up, the minimum of follow-up time is 25 months and the maximum is 129 months, 59 patients lost, follow-up rate is 81.33%(257/316 ), 3 deaths (non-TB causes of death), 18 cases of recurrence were the first recurrence of the original lesion, recurrent course of 25 months to 36 months, the recurrence rate of 7.0% (18/257), and 257 patients were included in the study, duration of 25 months to 129 months. The oldest age is 75 years, minimum 2, average 36.82±18.36 years, male 152 and female 105 cases, cervical 5 cases, thoracic 94 cases, thoracolumbar 84 cases and lumbar 74 cases. Used internal fixation 190, no-used 67. Lesions involving in 67 cases with one vertebral body and 190 cases with more than two vertebrae. Meanwhile, complicated spinal lesion 88 cases. The anti-TB treatment time of 232 post-operative cases is more than 6 months, The anti-TB treatment time of 229 preoperative cases is more than two weeks. COX proportional hazards regression model was used to analyse the correlation and the relative risk degree from the postoperative recurrence time and the 8 related factors which included age, sex, complicated spinal lesion, range of lesion, the number of lesions, pre/post-operative regular chemotherapy, and with/without internal fixation (debridement or/with bone graft and anterior lateral debridement bone grafting and internal fixation).Result: Multivariate Cox regression analysis showed that postoperative anti-TB treatment time (RR = 0.020, P = 0.000) and with/without internal fixation (RR = 0.055 P = 0.006) were significant correlate with the recurrence of spinal tuberculosis. The overall recurrence rate is 7% after post-operative 2-3 years.Conclusion: Postoperative regular anti-TB treatment, anterior lateral debridement and internal fixation can reduce the recurrence rate of spinal tuberculosis. the relapse time is centralize on 2-3 years after operation.