Analysis And Treatment Effects Of The Postoperative Reoccurence Of Spinal Tuberculosis

Objective: The present study aims to investigate the main reasons thatlead to the failure of spinal tuberculosis (TB) surgery and the effectivenessof reoperation. Furthermore to avoid the reoccurrence and promote theefficiency of surgical treatment of spinal tuberculosis.Methods: From July2012to November2013, there were138patientswith spinal tuberculosis (confirmed by pathological diagnosis) for the followup treatment. Among them,26patients underwent postoperative reoccurenceof spinal TB included in this study. The oldest age is86years old and theyoungest is1year old, average age38.53±19.39years, male18and female8cases, cervical1case, thoracic5cases, thoracolumbar7cases, lumbar13cases, used internal fixation18cases, no-used8cases, single lesionsinvolved8cases, multiple lesions involved18cases. The preoperative anti-TB treatment more than two weeks22cases, less than two weeks4cases.External skeletal TB (confirmed by radiographic examination)8cases,Technique used for the operation were divided into three, anterior17cases,posterior5cases, posterior and anterior combined3cases. SPSS COXregression survival analysis was used to analyze the correlation and therelative risk degree from the postoperative reoccurence time and otherrelated factors which included sex, age, complicated spinal lesions, number of lesions, duration of first pre-operative regular chemotherapy andpostoperative chemotherapy treatment, with or without internal fixation(debridement or/with bone graft and debridement bone grafting and internalfixation). The surgical circumstances for26patient which had reoccurrenceof spinal tuberculosis underwent reoperation to remove the excess abscess,closed monitoring of vital signs after operation by giving enough vitaminsespecially the neurological supplement, the objective of reoperation is forthe patient had normal daily activity.Result:①Input all10variables to spss16.0survival analysis CoxRegression (P value<0.05) indicated that from multiple variables it showed:first preoperative treatment duration (P=0.029); sites of infection (P=0.013,RR=3.653); surgical approach (P=0.020, R=0.094); duration of postoperative chemotherapy treatment (P=0.024, RR=0.070). These four factorswere considerably had correlation which affect the effectiveness of TBoperation and caused neurological deficiency in patients.②For thereoccurrence spinal tuberculosis patient our hospital underwent operation,which had reached the objective operation of spinal tuberculosis.Conclusion: Regular consumption preoperative and post operativechemotherapy TB treatment, debridement bone grafting and internal fixationcould reduce the occurrence of neurological deficit in reoccurrence operationtreatment of spinal TB.