Optimization of treatment of patients with tuberculosis spondylitis
Tuberculosis spondylitis is 40–61.5 % in the structure of bonearticular tuberculosis in adults.
Objective: to increase the efficiency of treatment of patients with tuberculous spondylitis of the thoracic and lumbar spine.
Methods: the results of treatment of 60 patients with active tuberculosis spondylitis were analyzed. At the group (n = 30) — at the stage of preoperative preparation were prescribed an intensive course (2–3 weeks) of specific antibacterial therapy taking into account the results of bacteriological sensitivity of microbacterial tuberculosis to antibacterial drugs; then surgical treatment was made with telescopic titanium cages for the front spine fusion. Group II (n = 30) — got 3–5 specific antibacterial for 2–3 months; subsequent surgical intervention involving the usage of autografts for the anterior spine fusion. The groups were identical in age, sex, number of affected vertebral motor segments, and activity of the infectious inflammatory process.
Results: excellent in the long follow-up period were obtained in 14 (54 %) patients in the 1st group and 8 (32 %) — II, good in 1 (24.7 %) and 7 (28 %); satisfactory — at 4 (15.4 %) and 7 (28 %) respectively. Only 3 (12 %) patients in group II were shown unsatisfactory results.
Conclusions: the proposed method of surgical treatment of tuberculosis spondylitis with the usage of modern achievements (the use of telescopic titanium cages) after short-term intensive antibacterial therapy, taking into account etiological diagnosis, is considered to be promising. In patients of group I, the results of treatment were significantly better due to a significant shortening of pre-surgery period, reducing the number of complications, reducing the timing of inpatient treatment and improving the quality of life.
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