THE RESULTS OF SURGICAL TREATMENT OF PATIENTS WITH ACTIVE TUBERCULOUS SPONDYLITIS

Authors:

Abstract:

The analysis of the treatment of 60 patients with active TS was performed. The main group (n=30) includes patients with lesions of the thoracic and lumbar vertebrae, operated using a telescopic titanium cage for ventral interbody spondylodesis after necrosequestrectomy. A feature of preoperative preparation of patients of the main group was the mandatory etiological diagnosis before treatment, the appointment of a short preoperative course of specific antibacterial therapy, taking into account the results of etiological diagnosis for 2–3 weeks, followed by surgery. The control group included patients (n=30) using traditional approaches to treatment – preoperative preparation using 3–5 specific antibacterial drugs without determining the sensitivity for 2–3 months, followed by surgery – decompressive necrectomy of the affected vertebrae and anterior spondylodesis using an autograft. In the comparative analysis of short-term and long-term results of surgical treatment of patients of both groups, the results were obtained, which clearly showed the high clinical effectiveness of the proposed method of treatment of patients of the main group using modern advances in vertebrology.

Keywords:

specific tuberculous lesions of the spine improvement of surgical treatment

References:

1. Brazhenko NA, redaktor. Vnelegochnyi tuberkulez: rukovodstvo dlya vrachei. Sankt-Peterburg: SpetsLit; 2013. 395 s. [in Russian]
2. Holka HH, Vesnin VV, Fadieiev OH, Oliinyk AO, Danyshchuk ZN, Novokhatska MF. Eksperymentalne modeliuvannia tuberkuloznoho spondylitu. Travma. 2018;19(5):64–71. [in Ukrainian]
3. Kurpita V, Kuzin I, Riabchenko K, Korinchuk L, Terleieva Ya, Kampos N, et al. Tuberkuloz v Ukraini: Analitychno-statystychnyi dovidnyk za 2018 rik. Kyiv: Tsentr hromadskoho zdorovia MOZ Ukrainy; 2019 [cited 2021 Trav 24]. 45 s. Available from: https://phc.org.ua/sites/default/files/users/user90/TB_surveillance_statistical-information_2018_dovidnyk.pdf [in Ukrainian]
4. Mushkin AYu, Vishnevsky AA, Peretsmanas EO, Bazarov AYu, Basankin IV. Infektsionnye porazheniya pozvonochnika: Proekt natsionalnykh klinicheskikh rekomendatsiy. Khirurgiya pozvonochnika. 2019;16(4):63–76. [in Russian]
5. Ulrikh EV, Mushkin AYu. Vertebrologiya v terminakh, tsifrakh, risunkakh. 3-e izd. Sankt-Peterburg: ELBI-SPb; 2006. 185 s. [in Russian]
6. Yablonskii PK, redaktor. Ftiziatriya: natsionalnye klinicheskie rekomendatsii. Moskva: GOETAR-Media; 2015. 230 s. [in Russian]
7. Chang JJ, Ma X, Feng HY, Huo JZ, Chen C, Zhang YN, et al. Clinical efficacy of single-stage posterior radical debridement, bone grafting and internal fixation in lumbar spinal tuberculosis with kyphotic deformity. Int J Clin Exp Med. 2016; 9(7):14383–9.
8. Chung TC, Yang SC, Chen HS, Kao YH, Tu YK, Chen WJ. Single-stage anterior debridement and fibular allograft implantation followed by posterior instrumentation for complicated infectious spondylitis: report of 20 cases and review of the literature. Medicine (Baltimore). 2014 Dec; 93(27):e190. doi: 10.1097/MD.0000000000000190
9. Denkinger CM, Schumacher SG, Gilpin C, Korobitsyn A, Wells WA, Pai M, et al. Guidance for the Evaluation of Tuberculosis Diagnostics That Meet the World Health Organization (WHO) Target Product Profiles: An Introduction to WHO Process and Study Design Principles. J Infect Dis. 2019 Oct 8; 220(220 Suppl 3):91–98. doi: 10.1093/infdis/jiz097
10. Jiang T, Zhao J, He M, Wang K, Fowdur M, Wu Y. Outcomes and Treatment of Lumbosacral Spinal Tuberculosis: A Retrospective Study of 53 Patients. PLoS One. 2015 Jun 29; 10(6):e0130185. doi: 10.1371/journal.pone.0130185
11. Khanna K, Sabharwal S. Spinal tuberculosis: a comprehensive review for the modern spine surgeon. Spine J. 2019 Nov; 19(11):1858–70. doi: 10.1016/j.spinee.2019.05.002
12. Moon MS. Tuberculosis of spine: current views in diagnosis and management. Asian Spine J. 2014 Feb; 8(1):97–111. doi: 10.4184/asj.2014.8.1.97
13. Wu W, Lyu J, Liu X, Luo F, Hou T, Zhou Q, et al. Surgical Treatment of Thoracic Spinal Tuberculosis: A Multicenter Retrospective Study. World Neurosurg. 2018 Feb; 110:842–850. doi: 10.1016/j.wneu.2017.11.126

Publication:

«World of Medicine and Biology» Vol. 18 No. 79 (2022) , с. 43-48
УДК 616.711-002.5 -089

DOI:

https://doi.org/10.26724/2079-8334-2022-1-79-43-48