Is duration of preoperative anti-tuberculosis treatment a risk factor for postoperative relapse or non-healing of spinal tuberculosis?
Is duration of preoperative anti-tuberculosis treatment a risk factor for postoperative relapse or non-healing of spinal tuberculosis?
复制标题
DOI：
10.1007/s00586-016-4496-2
复制
发表时间：
2016-12-01
影响因子：
2.8
通讯作者：
Chen, Jian-ting
中科院分区：
文献类型：
--
作者：
Ren, Hai-long;Jiang, Jian-ming;Chen, Jian-ting
本研究评估了脊柱结核术后复发或不愈合与术前抗结核治疗（ATT）持续时间的关系。对2004年1月至2013年1月接受脊柱结核手术且符合本研究纳入标准的患者进行回顾性分析。观察参数为年龄、性别、初始ESR、术前ESR、ESR变化程度、初始CRP、术前CRP、CRP变化程度、术前ATT持续时间、手术入路、是否内固定、脊柱病变部位、累及节段数、手术时间和术中失血量。对数据进行单变量和多变量分析，以确定脊柱结核复发或不愈合的相关危险因素。共有223名患者符合纳入标准。其中女性84例，男性139例，平均年龄42.2岁（范围2-85岁）。随访时间18～72个月（平均28.7个月）。在观察的223名患者中，23名患者在随访期间出现术后复发或不愈合（10.3%）。统计分析表明，脊柱病变的位置与术后复发或不愈合显着相关。胸腰段结核术后复发或不愈合的风险是腰骶部结核的2.524倍（95% CI 1.026-6.580）。术前ATT持续时间可能不是脊柱结核术后复发或不愈合的危险因素。交界区如腰骶部和胸腰交界区的复发率高于非交界区。
This study evaluated the relationship between spinal TB postoperative recurrence or non-healing and duration of preoperative anti-TB treatment (ATT).From January 2004 to January 2013, patients who underwent surgery for spinal TB and met this study's inclusion criteria were retrospectively reviewed. Observed parameters were age, sex, initial ESR, preoperative ESR, degree of ESR change, initial CRP, preoperative CRP, degree of CRP change, duration of preoperative ATT, surgical approach, presence of internal fixation, location of spinal lesion, number of involved segments, duration of operation, and intraoperative blood loss. The data were analyzed by univariate and multivariate analyses for spinal TB recurrence or non-healing to determine related risk factors.A total of 223 patients met the inclusion criteria. There were 84 female and 139 male patients with a mean age of 42.2 years (range 2-85 years). The follow-up period was 18-72 months (average 28.7 months). Among 223 patients observed, 23 patients had postoperative relapse or non-healing (10.3 %) during the follow-up period. Statistical analysis indicated that the location of a spinal lesion was significantly associated with postoperative relapse or non-healing. Risk of postoperative relapse or non-healing in thoracolumbar TB was 2.524-fold (95 % CI 1.026-6.580) that of lumbosacral TB.Duration of preoperative ATT may not be a risk factor for postoperative recurrence or non-healing of spinal TB. Junctional zones such as the lumbosacral and thoracolumbar junction have a higher recurrence rate than non junctional.