Banik Souvik, Madavi Sheetal
Anaesthesiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2024 May 8;16(5):e59871. doi: 10.7759/cureus.59871. eCollection 2024 May.
Pott's spine, or tuberculous spondylitis, remains a significant public health concern in regions where tuberculosis is endemic. The management of Pott's spine poses unique perioperative challenges due to the complexity of the disease process, including vertebral destruction, spinal instability, and neurological compromise. This comprehensive review explores the intricacies of navigating perioperative challenges in Pott's spine surgery. Beginning with an overview of Pott's spine, including its etiology, clinical presentation, and classification, the review delves into the significance of perioperative challenges in this condition. Emphasis is placed on the need for multidisciplinary collaboration, meticulous preoperative assessment, and tailored surgical planning to optimize outcomes while minimizing the risk of complications. Critical considerations in the preoperative, intraoperative, and postoperative phases of care are discussed in detail, including patient assessment, imaging modalities, surgical techniques, anesthesia considerations, and postoperative rehabilitation. Special considerations such as pediatric Pott's spine and multidrug-resistant tuberculosis are also addressed. The review concludes by summarizing key points, highlighting implications for clinical practice, and providing recommendations for future research. By synthesizing current evidence and clinical expertise, this review offers valuable insights into the optimal management of perioperative challenges in Pott's spine, ultimately aiming to improve patient outcomes and reduce the burden of this debilitating condition.
波特氏脊柱病,即结核性脊柱炎,在结核病流行地区仍然是一个重大的公共卫生问题。由于疾病过程的复杂性,包括椎体破坏、脊柱不稳定和神经功能损害,波特氏脊柱病的治疗在围手术期面临独特的挑战。这篇综述探讨了波特氏脊柱手术中应对围手术期挑战的复杂性。综述首先概述了波特氏脊柱病,包括其病因、临床表现和分类,然后深入探讨了这种情况下围手术期挑战的重要性。重点强调了多学科协作、细致的术前评估和量身定制的手术规划的必要性,以优化治疗效果,同时将并发症风险降至最低。详细讨论了术前、术中和术后护理阶段的关键考虑因素,包括患者评估、影像学检查方法、手术技术、麻醉注意事项和术后康复。还讨论了小儿波特氏脊柱病和耐多药结核病等特殊考虑因素。综述最后总结了要点,强调了对临床实践的影响,并为未来研究提供了建议。通过综合当前证据和临床专业知识,本综述为波特氏脊柱病围手术期挑战的最佳管理提供了有价值的见解,最终旨在改善患者预后,减轻这种致残性疾病的负担。