Risk factors analysis of the postoperative complications in spinal tuberculosis patients / 中华骨科杂志

ABSTRACT

Objective To investigate the risk factors of postoperative complications in spinal tuberculosis surgery,and try to find a way to improve the results of perioperative management and reduce or avoid the postoperative complications.Methods All of 172 cases of spinal tuberculosis who were treated by surgery from February 2005 to January 2013 in orthopedic department of Zhongshan hospital,Fudan University were retrospectively analyzed.There were 88 males and 84 females,whose average age was 50.9± 18.7y (18-84y).Among them 98 cases got cold abscess,and 56 cases had tuberculosis poisoning symptoms.The lesions located mostly in thoracic spine (112/172,65.1％) and lumbar spine (40/172,23.3％),while rarely in cervical or sacral spine.2 intervertebral spaces were involved in 116 cases (67.4％),more than 2 intervertebral spaces were involved in 32 cases (18.6％),and single intervertebral space were involved in the rest cases (14.0％).38 cases were treated through single anterior approach,54 cases were treated by anterior-posterior surgical approach,and single posterior approach was performed in 80 cases.58 cases were suffered from neurological dysfunction.All the postoperative complications and related clinical parameters during hospitalization period were collected and analyzed with SPSS software.Each clinical parameter was analyzed with univariate analysis to find the factors related to postoperative complications,and then the related factors were analyzed by multivariate regression analysis.Results All of 172 patients were included and 41.9％ (72/172) of the patients suffered from postoperative complications.System complications were the most common (33.7％,58/172).The rates of local complications were 10.5％ (18/172).Univariate analysis showed that the lesion site,value of hemoglobin,electrolyte disturbances,postoperative ASIA score and blood loss were related with postoperative complications.Posterior approach related with local complications.Multivariate regression analysis showed that preoperative hemoglobin ＜100 g/L,poor postoperative ASIA scores and long period of preoperative anti-TB treatment (＞28 days) were related with the system or local postoperative complications.Conclusion Patients with anemia (hemoglobin ＜ 100g/L),poor postoperative neurological function and long period of preoperative anti-TB treatment could take more risks of the postoperative complications.