Causes and countermeasures of complications of one-stage surgical management for spinal tuberculosis / 中国医师进修杂志

ABSTRACT

Objective To analyze the causes of the complications of one-stage surgical management for spinal tuberculosis and its countermeasures.Methods From May 1997 to December 2008,116 patients with spinal tuberculosis underwent operations.Among them,6 were in cervical vertebra,3 in cervicothoracie vertebra,29 in thoracic vertebra,37 in thoracolumbar vertebra.29 in lumbar vertebra and 12 in hmbrosacrum vertebra.All cases underwent the anterior and/or radical debridement,decompression,autogenous bone grafting or radical debridement,decompression,autogenous bone grafting and internal fixation.The causes of the complications of surgical management and the countermeasures were analyzed.Results One hundred and ehven cases were followed upfor an average of(3.86±2.16)years(range 6 months to 12 years).The rate of complication was 13.5%(15/111).Recurrent spinal tuberculosis occarred in 5 cases,internal fixation loosened in 1 case,rupture of the external iliac vein occurred in 2 cases,lateral ventral syndrome in 1 case,venous embolism of the lower extremity in 1 csse,reactional psychosis in 2 cases,pneumatothorax in 2 cases and femoral nerve irritating syndrome in 1 case.Among the recurrent cages,2cases with anterior debridement and 2 cases with posterior debridement underwent anterior operation again andgot good results, 1 case with anterior debridement gave up the reoperafion.Other cases relieved after conservative therapy.Conclusions Standardized anti-tuberculosis thempy is fundamental for preventing the recurrence of tuberculosis.Correct approach for the operation and thorough radical debddement are the key points for preventing the recurrence of tuberculosis.Good and effective therapy surround the operation is helpful for preventing the recurrence of tuberculosis.