The Operative Treatment And Perioperative Retrospective Analysis Of76Cases Of Senile Osteoporosis Patients With Spinal Tuberculosis

ObjectiveRetrospective analysis of76cases of spinal tuberculosis with senile osteoporosis patients in clinical treatment and perioperative management, and explore the risk factors affecting the efficacy.MethodsRetrospective analysis of September2008-September2011,96cases of elderly patients with spine tuberculosis with osteoporosis patients in our hospital, of which76cases were followed up information,be included in this study.The76patients according to accept a variety of individualized treatment principles and perioperative. According to the disease,they get targeted surgical for tuberculosis debridement and pedicle screw fixation and fusion treatment. Statistical analysis of preoperative, postoperative and final follow-up recorded ESR, cobb angle, nerve function, bone density and other data.ResultsA total of76patients were followed up information, including34males and42females, aged65to81years, mean73±8years; postoperative follow-up18to54months, the average follow-up time of36±18months. Operative bleeding volume680ml～1100ml, the average amount of bleeding860±180ml; intraoperative blood transfusion600ml～1200ml, an average of900±300ml.Surgery does not appear significantly related complications.Two cases of postoperative complications, Unhealed wound one case, stress disorder one case. All patients physiological curvature of the spine has been significantly restored and to the final follow-up there was no significant loss of orthopedic, neurological function was significantly improved compared with the previous(just the two cases Frankle grade restored to Grade D, E-Class the other)ESR and other biochemical markers were normal, osteoporosis confirmed by bone densitometry significant improvement over the previous(BMD0.651to0.757,T-3.4to-1.4).9-12months after surgery,all the patients obtained bone fusion, Solid and reliable fixation,until to last follow-up, there were not pedicle screw loose, comes out or broken, no pseudarthrosis, never appear junctional kyphosis.Conclusions(1) Persistent nutritional support, continuous anti-osteoporosis drug intervention, sustained long-law norms combined antituberculosis chemotherapy individualized perioperative treatment could significantly improve osteoporosis in elderly patients with the disease, and enhance the patient’s body, relieve symptoms of tuberculosis, to create the conditions for the operation and reduce the incidence of complications, make treatment to achieve better results.(2) Choose targeted surgical based on condition, and properly deal with the use of various types of surgical techniques curved stick, tapping, debridement and other surgical difficulties, could significantly reduce the risk of fixation failure and increase the fusion rate, make surgery to achieve better efficacy.