Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University College of Medicine, No. 76 Nanguo Road, Xi'an, 710054, Shanxi, China.
Sci Rep. 2018 May 2;8(1):6933. doi: 10.1038/s41598-018-25142-z.
Recurrent complex spinal tuberculosis accompanied by sinus tract formation is one of the most common and complex types of recurrent tuberculosis. To date, only very few studies have reported the strategies and effectiveness of surgical treatments on postoperative recurrent spinal tuberculosis accompanied by sinus tract formation. In this study, 21 recurrent patients out of 87 patients with complex spinal tuberculosis were reviewed. The data of the patients, including age, gender, existence of drug-resistant mycobacterium tuberculosis, postoperative standard chemotherapy, completeness of lesion debridement, reconstruction of the spinal stability, nutritional status, accompaniment by tuberculosis in other regions, timing of the operations, and areas of the lesions, were collected for single- and multiple-factor analyses. The clinical outcomes were evaluated by long-term follow-ups. The results showed that 7 factors were significantly associated with postoperative recurrence of complex spinal tuberculosis accompanied by sinus tract formation. This suggested that when we treat complex spinal tuberculosis, we should pay more attention to these seven indicators to avoid postoperative recurrence, and our clinical outcomes suggested that it is difficult to treat recurrent complicated spinal tuberculosis combined with sinus tract formation. The key for successful surgical treatment includes effective chemotherapy, radical debridement and proper reconstruction of spinal stability.
复发性复杂脊柱结核伴窦道形成是最常见和复杂的复发性结核之一。迄今为止，仅有极少数研究报道了手术治疗伴窦道形成的复发性脊柱结核的策略和效果。本研究回顾了 87 例复杂脊柱结核患者中的 21 例复发性患者。收集了患者的年龄、性别、是否存在耐药结核分枝杆菌、术后标准化疗、病变清创的完整性、脊柱稳定性重建、营养状况、其他部位结核的伴随情况、手术时机和病变部位等数据，并进行单因素和多因素分析。通过长期随访评估临床结果。结果显示，7 个因素与伴窦道形成的复发性复杂脊柱结核术后复发显著相关。这提示我们在治疗复杂脊柱结核时，应更加关注这七个指标，以避免术后复发，我们的临床结果表明，治疗伴窦道形成的复发性复杂脊柱结核较为困难。手术成功的关键包括有效的化疗、彻底清创和适当的脊柱稳定性重建。
