Yao Yuan, Zhang Huiyu, Liu Minghan, Liu Huan, Chu Tongwei, Tang Yu, Zhou Yue
Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Department of Stomatology, the 457th Hospital of PLA, Wuhan, China.
World Neurosurg. 2017 Sep;105:327-331. doi: 10.1016/j.wneu.2017.05.167. Epub 2017 Jun 26.
Thoracic spinal tuberculosis (TST) is a dangerous disease. Besides antituberculosis chemotherapy, surgery is also necessary for treating TST. To date, no study has focused on the prognostic factors for recovery of patients after surgery for TST.
From 2001-2016, 237 patients who underwent surgery for TST in our department were included in this study. Japanese Orthopedic Association score was used to assess recovery after surgery. Kaplan-Meier method and Cox regression analysis were employed to identify the significant prognostic factors.
Univariate analysis demonstrated that diabetes, paralysis, kyphosis, duration of symptoms (≥3/<3 months), and number of involved vertebrae (>2/≤2) were identified as potential prognostic factors responsible for recovery after surgery for TST. Multivariate analysis suggested that paralysis, duration of symptoms (≥3/<3 months), and number of involved vertebrae (>2/≤2) were identified as the significant prognostic factors responsible for recovery after surgery for TST.
This study supports the previously published evidence that nonparalysis, shorter duration of symptoms, and fewer involved vertebrae are favorable prognostic factors for recovery after surgery for TST. For a better recovery effect, the key points for treating TST were timely diagnosis and treatment. It is urgent for government to arouse attention and popularize the knowledge of spinal tuberculosis.
胸椎结核（TST）是一种危险的疾病。除抗结核化疗外，手术也是治疗TST所必需的。迄今为止，尚无研究关注TST手术后患者恢复的预后因素。
2001年至2016年，我科237例行TST手术的患者纳入本研究。采用日本骨科学会评分评估术后恢复情况。采用Kaplan-Meier法和Cox回归分析确定显著的预后因素。
单因素分析表明，糖尿病、瘫痪、脊柱后凸、症状持续时间（≥3/<3个月）和受累椎体数量（>2/≤2）被确定为TST手术后恢复的潜在预后因素。多因素分析表明，瘫痪、症状持续时间（≥3/<3个月）和受累椎体数量（>2/≤2）被确定为TST手术后恢复的显著预后因素。
本研究支持先前发表的证据，即无瘫痪、症状持续时间较短和受累椎体较少是TST手术后恢复的有利预后因素。为获得更好的恢复效果，治疗TST的关键是及时诊断和治疗。政府迫切需要引起关注并普及脊柱结核知识。
