Cause analysis and prevention of the complications after surgical treatment for spinal tuberculosis

English Keywords:Spinal  Tuberculosis  Complications  Prevention

English Abstract:

  【Abstract】 Objective：To explore the types，causes，treatment plans and prevention of the complications after surgical treatment for spinal tuberculosis.Method：306 cases of spinal tuberculosis undergoing posterior or anterior debridement，bone graft with or without instrumentation from June 2004 to December 2009 were retrospectively reviewed，including 173 males and 133 females，with the mean age of 34.5 years old（range， 17 to 68 years）．Of them，there were 16 cervical tuberculosis，5 cervicothoracic tuberculosis，77 thoracic tuberculosis，104 thoracolumbar tuberculosis，76 lumbar tuberculosis and 28 lumbosacral tuberculosis.All cases were followed-up for an average of 18 months（6 months-3 years）．The causes of complications and corresponding interventions were documented.Result：10 cases were lost during follow-up and complications were noted in 47 patients（15.4%）.Injury of pleuroperitoneum was noted in 5 cases，injury of external iliac vein in 4 cases，neurological deficit in 3 cases.Surgical stress reaction occurred in 4 cases and deep vein thrombosis occurred in 3 cases which were all resolved after corresponding conservative treatment；4 cases were complicated with dyspnoea，of who 2 died，CSF leakage was noted in 5 cases，3 underwent consistent drainage and 2 recovered.2 cases suffered early-stage bony graft related to complication which resolved by debridement;instrument failure were noted in 2 cases；7 cases were noted tuberculosis recurrence，of who，2 underwent single anterior debridement，2 underwent anterior debridement and instrumentation，2 underwent anterior debridement plus posterior pedicle screw fixation，while 2 cases underwent conservative treatment.The skin incision healed primarily in all patients.Conclusion：Postoperative complications of spinal tuberculosis should be taken into account.Strict chemotherapy and strict surgical indications，proper surgical maneuver are key to preventing the complications.